Gender perspective and sexual diversities in the curriculum of Occupational Therapy at the University of Magallanes

Abstract

In professional training, including teaching with a gender and sexual diversity perspective will promote a critical sense towards the issues mentioned here, strengthening a vision of respect for human rights, which is evident in the subsequent treatment of the diversity of people who will require attention from health professionals and other areas of the academic world. Considering the minimum standards for professional training of occupational therapists of the World Federation of Occupational Therapy, 2016, which contemplate the commitment to inclusion, human rights and diversity, it would be expected to provide students with an education that considers the gender and sexual diversity perspective, in response to the social responsibility and commitment of education in respect for human dignity and appreciation of diversity, avoiding situations of violence, invisibility and violation of rights of people and groups that have been historically violated (Chile, 2023). [...]it is important to consider these aspects in professional training, aimed at fulfilling a fundamental role in improving people's quality of life, promoting social inclusion and well-being. Occupational therapists are concerned about Human Rights in the search for occupational justice for all people, through active participation in meaningful activities, creating fair and inclusive societies (Hocking et al., 2022).

Headnote

Abstract

Introduction: This research focuses on concepts of sexual diversity, gender perspective and curriculum; showing whether or not are they present in the undergraduate Occupational Therapy training, at the University of Magallanes, Chile. Objective: To know the existence and manifestations of gender and sexual diversity perspectives in the occupational therapy curriculum. Method: Mixed study, with descriptive scope and feminist design with gender perspective, where data is collected from official documents (curriculum and subject programs) and from the experiences and stories of students and teachers. Results: Whit respect to the curriculum of the Occupational Therapy degree 2020, it is possible to observe the preferential use of masculine, the inexistence of typographic strategies, splitting, or other alternative strategies. In relation to the use of inclusive language in the degree programs, a total of 23 subject programs were reviewed, in which it can be seen that there is a majority effort to be inclusive, being the most used strategies the use of neutral expressions and impersonal forms. Regarding to the perceptions of teachers and students on the inclusion of gender and sexual diversity perspectives in the hidden curriculum of the occupational therapy degree and classroom strategies, it was evidenced that both groups recognized the importance of these approaches for a more equitable learning. Conclusion: An evolution is observed over time, with more inclusive practices, being necessary even more development.

Keywords: Gender Perspective, Gender Diversity, Curriculum, Occupational Therapy, Sexism.

Resumen

Int roducción: Esta investigación se centra en conceptos de diversidad sexual, perspectiva de género y currículo; evidenciando si estos se encuentran o no presentes, en la formación de pregrado de Terapia Ocupacional de la Universidad de Magallanes de Chile. Objetivo: Conocer la existencia y manifestaciones de las perspectivas de género y diversidades sexuales en el currículo de terapia ocupacional. Método: Estudio mixto, con alcance descriptivo y diseño feminista con perspectiva de género, donde se recolectan datos de documentos oficiales (plan de estudios y programas de asignaturas) y desde las experiencias, vivencias y relatos de estudiantes y docentes. Resultados: Respecto al plan de estudios de la carrera de Terapia Ocupacional 2020, se puede observar uso preferente de masculino, inexistencia de estrategias tipográficas, desdoblamiento, u otras estrategias alternativas. En relación al uso del lenguaje incluyente en los programas de la carrera, se revisaron un total de 23 programas de asignatura, en los cuales se aprecia que existe un esfuerzo mayoritario por ser incluyentes siendo las estrategias más utilizadas el uso de expresiones neutrales y formas impersonales. En cuanto a las percepciones de docentes y estudiantes sobre la inclusión de perspectivas de género y diversidades sexuales en el currículo oculto de la carrera de Terapia ocupacional y las estrategias de aula, se evidenció que ambos grupos reconocieron la importancia de estos enfoques para un aprendizaje más equitativo. Conclusion: Se observa una evolución a lo largo del tiempo, con prácticas más inclusivas, siendo necesario aún más desarrollo.

Palabras claves: Perspectiva de Género, Diversidad de Género, Curriculum, Terapia Ocupacional, Sexismo.

Resumo

Introdução: Esta pesquisa se concentra nos conceitos de diversidade sexual, perspectiva de gênero e currículo, mostrando se eles estão ou não presentes na formação de graduação em Terapia Ocupacional da Universidade de Magallanes, Chile. Objetivo: Determinar a existência e as manifestações das perspectivas de gênero e diversidade sexual no currículo de terapia ocupacional. Método: Estudo misto, com escopo descritivo e desenho feminista com perspectiva de gênero, em que os dados são coletados de documentos oficiais (programa de estudos e programas de disciplinas) e das experiências, vivências e histórias de alunos e professores. Resultados: Em termos ao plano de estudos do curso de Terapia Ocupacional 2020, é possível observar o uso preferencial do masculino, a inexistência de estratégias tipográficas, de divisão ou de outras estratégias alternativas. Em relação ao uso da linguagem inclusiva nos programas de graduação, foram analisados 23 programas de disciplinas, nos quais se pode observar que há um esforço majoritário para ser inclusivo, sendo as estratégias mais usadas o uso de expressões neutras e formas impessoais. Em termos de percepções de professores e alunos sobre a inclusão de perspectivas de gênero e diversidade sexual no currículo oculto do curso de terapia ocupacional e estratégias de sala de aula, ficou evidente que ambos os grupos reconheceram a importância dessas abordagens para um aprendizado mais equitativo. Conclusão: Houve uma evolução ao longo do tempo, com práticas mais inclusivas, sendo ainda necessário mais desenvolvimento.

Palavras-chave: Perspectiva de Gênero, Diversidade de Gênero, Currículo, Terapia Ocupacional, Sexismo.

Introduction

In recent decades, the gender perspective and sexual diversity have been priority issues on the international agenda of Human Rights and education, considering they have become more relevance after the student demands and protests of recent years, making clear the need for an education free of sexism. There are social gaps in the educational field, which generate inequalities and injustices that influence the health and social justice of the university community, therefore, knowing and evidencing the presence of this social problem that replicates a heteronormative and androcentric model (Nuño Gómez& Enrique Álvarez, 2017), forces us to analyze how they are expressed in professional training. Taking the above into account, the university, being an educational institution and transmitter of values, must promote social change and educate with equality, being a space for the beginning of more global cultural changes.

In professional training, including teaching with a gender and sexual diversity perspective will promote a critical sense towards the issues mentioned here, strengthening a vision of respect for human rights, which is evident in the subsequent treatment of the diversity of people who will require attention from health professionals and other areas of the academic world.

Considering the minimum standards for professional training of occupational therapists of the World Federation of Occupational Therapy, 2016, which contemplate the commitment to inclusion, human rights and diversity, it would be expected to provide students with an education that considers the gender and sexual diversity perspective, in response to the social responsibility and commitment of education in respect for human dignity and appreciation of diversity, avoiding situations of violence, invisibility and violation of rights of people and groups that have been historically violated (Chile, 2023). Otherwise, when these issues are not explored or taken into account during professional training, there is a risk that they will be aspects that are dispensable and made invisible by professionals in training, which will perpetuate discrimination and invisibility of sexual diversity, sexism within the professional field and in its interventions, negatively affecting the well-being and health of those affected and society as a whole.

This research has been developed under a conscious and committed approach to inclusivity, making full use of inclusive language. The inclusive approach is based on the critical review of different manuals (Guichard, 2018) and normative texts (Rifà Valls et al., 2024), which in addition to providing guidelines for their use, reveal their influence on the historical reproduction of hegemonic, binary and androcentric practices, of discrimination and invisibility of women and sexual diversity, making their transformation necessary, incorporating practices that seek to recognize and respect the diversity of people and gender identities, incorporating the gender perspective (Philipp& Vázquez, 2021), which allows the visibility of different people with their specific characteristics as part of the community.

Asymmetries, inequalities and gaps between the sexes are also manifested in language. This is because language forms a set of abstract constructions in which judgments, values and prejudices that are learned and taught, which shape ways of thinking and perceiving reality (Guichard, 2018, p. 9).

In line with these guidelines, the use of generic pronouns and dominants has been dispensed with, choosing neutral language and avoiding binary gender assignment. In addition, the use of the vowel "e" (in Spanish) has been implemented as a lexical resource to maintain coherence in the research and respect for the students who participated in the focus group, who identified themselves with neutral or non-binary pronouns. This grammatical choice reflects our commitment to the inclusion and recognition of sexual diversity present in the student context investigated, thus contributing to the development of a discourse that reflects sensitivity, respect for the plurality of identities and that promotes equality.

This research will focus mainly on topics that are of contemporary relevance, such as the gender perspective and sexual diversity, which will be challenges that, in the future as occupational therapists, we must face and incorporate into professional practice, adapting according to the changes experienced in society both locally and globally.

Therefore, it is important to consider these aspects in professional training, aimed at fulfilling a fundamental role in improving people's quality of life, promoting social inclusion and well-being. Occupational therapists are concerned about Human Rights in the search for occupational justice for all people, through active participation in meaningful activities, creating fair and inclusive societies (Hocking et al., 2022).

It should be noted that the Occupational Therapy degree began in Chile more than 60 years ago, having maintained an interest in people, health and well-being since its origins. By adhering early to the guidelines and basic requirements issued by the World Federation of Occupational Therapists [WFOT], an entity that has incorporated and declared in recent decades aspects such as justice and respect for human rights as part of the heart of the profession (Hocking et al., 2022), one of the objectives being the social inclusion of people, considering them as unique and unrepeatable. In accordance with the above, it is critical to know how these elements and other emerging ones such as the gender perspective and sexual diversity are currently incorporated into the training of professionals in this discipline.

The Occupational Therapy degree in Magallanes was created in 2003, taking as a reference the minimum standards of professional training of the WFOT and socializing the project with the College of Occupational Therapists of Chile, currently with academic and administrative dependence on the Faculty of Health Sciences. In December 2007, its first class graduated.

At the University of Magallanes, the graduate profile of the occupational therapist professional, as well as its mission and vision, aim at the training of professionals with a solid disciplinary training, who are oriented towards ethics and occupational justice, promoting profound social changes (Universidad de Magallanes, 2024).

University education allows the acquisition and enhancement of competencies and skills that are delivered within the academic curriculum where students can perform adequately and adaptively in different contexts. The curriculum can be defined as "[...] the organization of what must be taught and learned" (Nayive Angulo& León, 2005), or more profoundly, seen as a model or design that organizes the necessary path for each student to acquire certain knowledge, skills and attitudes, which arise from the educational project of their institution and/or degree. In teaching practice, this curriculum is subdivided into three types of curricula that interact with each other, the formal, the informal and the hidden (Torres, 1995; Antúnez et al., 2009, as cited in

Centeno& de la Paz Grebe, 2021). The formal curriculum refers to explicit aspects, defined in terms of content, objectives and methodologies aimed at fulfilling the study plan and programs that we generally find written in official documents. The informal curriculum that according to Centeno& de la Paz Grebe (2021), refers to the concrete aspects involved in the implementation of the study plan and includes the interaction between teachers and students, associated with the fulfillment of pedagogical objectives, and the hidden curriculum which:

It consists of non-explicit and/or non-intentional learning (values, attitudes, knowledge, skills, meanings, abilities, assumptions) that take place in the school environment, not only in the classroom or in the teaching process itself, but are reproduced and/or expressed both in elements linked exclusively to this process..., as well as in power relations and with authority, codes and forms of communication, verbal and non-verbal language, school and social interactions... (Maceira Ochoa, 2005, pp. 195).

Both the informal and hidden curriculum go beyond what is planned or predictable and, according to some authors, represent the most important aspects of real learning linked to both professional and institutional identity. The hidden curriculum could be understood as the transfer of the institutional culture or way of being to the new members of the academic community, including routines, habits, beliefs and values, among other messages that are transmitted in formal and non-academic settings within the university, which may reinforce or contradict the content and learning objectives (Centeno& de la Paz Grebe, 2021).

Currently, as Pinar points out, education does not consist of an exchange and acquisition of information. Information must be in tension with intellectual judgment, critical thinking, ethics and self-reflection (Pinar, 2014), the latter, moreover, are not taught formally at the different educational levels. That is, those elements that are not usually within the curriculum, are the emotional elements of those people to whom the curricular plan is directed. According to Ruiz, within the curricular plan, there should be 5 important objectives that are, in addition, types of human capacities; cognitive or intellectual, motor, personal balance or affective and social performance or insertion (Ruiz, 2020). Those aspects that are not taught within the classroom and that are acquired by students outside a pure academic context, understood as that context in which one is not under constant teacher supervision, and consequently, out of the designed curricular plan.

Within the curriculum of the different degrees, there will be guidelines that will allow achieving an approximate profile of what that degree seeks, which is why the elements of said curriculum must be kept up to date over time, with the aim of having professionals who are increasingly relevant to the different emerging realities, such as the gender perspective and the LGBTIQA+ community, among others. Furthermore, it is perceived that "...Latin American women and sexual and gender dissidents actively seek their recognition as social and political agents: within the societies of origin and destination" (Villarreal Villamar et al., 2023, p. 22), that is, they are the same groups that have been violated, those who are raising their voices for change and for their visibility. As professionals in training, it is necessary to obtain greater resources and knowledge from university spaces in order to ensure, in the best possible way, the achievement of inclusive and violence-free spaces that respect diversity on equal terms.

It is also worth highlighting the importance of non-sexist education, which considers equal participation, breaking down gender stereotypes that may exist within their contexts (Vidal Velis et al., 2020). The above should be contemplated in the formal and hidden curriculum of the different degrees, especially in the health field, for the early learning of the different considerations to be incorporated in the respectful and equal treatment towards the people who will access our services.

Part of the inclusion and respect for people is not making them invisible and providing equal opportunities to different groups that make up society, which is why within the training of occupational therapists the gender perspective becomes critical.

In addition, the approach and female participation were fundamental for the development of our profession, managing to expand thanks to women's networks and acquiring a degree of autonomy outside the exclusive male-medical domain, prevailing in its time of origin. The contributions of pioneering women helped to achieve greater value in the field of knowledge not only through practice, but also through writings and publications of articles in the discipline (Morrison Jara, 2016).

The gender perspective can be defined as "[...] an analytical tool that studies the way in which the sociocultural characteristics assigned to people based on sex transform sexual difference into social inequality", (Nerio Monroy, 2019, p. 42). Covering not only the binary as masculine and feminine, but all the diversity that exists in the human being. Besides the gender perspective and non-sexist education, we find it relevant to incorporate the concept of diversity in general terms, considering each person as unique and unrepeatable. Diversity refers to the variety of characteristics and qualities within a group, community or society, whether cultural, sexual, biological, functional, age, gender, emotional, among others (Guédez, 2005), differentiating itself from the concept of sexual diversity, defined as the "[...] different ways of expressing affectivity, eroticism, desire and loving practices, as well as assuming identities and preferences that are not limited to what we know as heterosexuality" (Mexico, 2012, p. 11), this freely in the society or the community in general, expressing itself in different ways, not only in a binary way, but also with the freedom to live sexuality with endless options (Palma et al., 2022).

According to some research, the incorporation of the gender perspective in the curriculum has been studied, as Valenzuela and Cartes mention, the absence of a gender perspective in vocational training generates gaps in health care, mainly affecting women and people from the LGBTIQA+ community (Valenzuela& Cartes, 2019), with the understanding and incorporation of legislative aspects and the use of language to support and include people of sexual and gender diversity being a relevant subject.

Just as in the field of disability the incorporation of inclusive language has been going on for some time, the term functional diversity is currently used, since the word "disability" refers to limiting terms to name a group of people, a gap that must be broken with professionals in training, teaching the population on how to properly name people, achieving greater social and verbal inclusion (Romañach& Lobato, 2005). There are different types to classify functional diversity, such as motor, sensory, auditory, visual and intellectual.

Also from the perspective of gender and sexual diversity, according to Nash, one should:

Eliminate the legitimacy and reproduction of subordination and inequality, by overcoming gender stereotypes and hierarchies and aiming towards an equitable society, with coexistence based on respect and real, not formal, equality, to achieve full development of the potential of each member of the educational community (Nash, 2018, p. 126)

Inclusive language is an intervention in public discourse, which aims to have an impact on the audience such as reporting situations of inequality between men and women, in order to achieve cultural change and social impact, this refers to the discursive configuration that surrounds the political struggle regarding women's issues, therefore it is considered a rhetorical-political phenomenon rather than a linguistic one (Kalinowski et al., 2020). Its origin was directly related to the demonstrations of a large part of the population, becoming an option also for a minority group such as non-binary people, demonstrating that this intervention of inclusive language has the rare capacity to cover visibility needs of both genders and diversities, with the aim of having an effect linked to the recognition of individual or even collective identity (Kalinowski et al., 2020).

This study is part of a larger research project, which includes all the University's degrees, called "Gender perspective and sexual diversity in the curriculum of the technical and professional degrees at the University of Magallanes", which is being conducted by academics Eterovic, Estefó, Palma and Venegas. In our version, the search for information is focused on the Occupational Therapy degree, considering the review of programs, interviews with teachers and a focus group of students.

What is sought and expected through this research is to know and identify how the gender perspective and sexual diversity are manifested in the field of professional training of occupational therapists at the University of Magallanes, specifically through the review and analysis of the curriculum of the Occupational Therapy degree, to make visible and show how the topics mentioned above are developed through educational processes.

We want to answer the following research question: Is there a gender and sexual diversity perspective in the academic curriculum of the occupational therapy degree at the University of Magallanes?, with the aim of understanding the existence and manifestations of gender perspectives and sexual and gender diversity in its curriculum.

Not knowing the gender and sexual diversity perspective has a negative impact on the comprehensive training of professionals, since it is possible to carry out discrimination processes or carry out a non-inclusive professional practice simply because of not knowing these realities. This lack of knowledge can increase the vulnerability of segregated groups, mainly affecting women and people who belong to diversities, causing negative consequences on self-esteem, self-concept, occupational marginalization, social participation and consequent physical and emotional health problems.

Method

The research proposes a mainly qualitative approach, which is based on evidence that allows the description of a phenomenon in order to understand and explain it. Moreover, it provides depth to the data, provides interpretive richness and a holistic point of view of the phenomena to be studied (Sánchez Flores, 2019), in this particular case the manifestation of the gender perspective and sexual diversity in the curriculum of the Occupational Therapy degree at the University of Magallanes.

It has a descriptive scope that consists of describing phenomena by specifying their important properties, aiming to measure or collect information independently or jointly (Hernández Sampieri et al., 2014). The research will describe the experiences and stories of the participants around the educational curriculum and how the gender perspective and sexual diversity are manifested.

The design is feminist with a gender perspective, which arises from the need to study a phenomenon that requires attention and with expectation for improvement, along with going against "academic normality" (Jiménez Cortés, 2021). This research also has a phenomenological design, which allows to explore, describe and understand subjectivities, such as experiences, perceptions or opinions of people in relation to a phenomenon (Hernández Sampieri et al., 2014), which is why it is oriented to know the experiences of teachers and students regarding the gender perspective in academic training and teaching practice. In this way, an analysis of the content of the discourse of participants in the academic process, that is, teachers and students, is carried out, along with reviewing whether there are manifestations of the gender perspective and sexual diversity in the study plan and the subject programs of the Occupational Therapy degree at the University of Magallanes.

Instruments

Checklist

An ad hoc checklist is carried out in the review of subject programs and study plan of the Occupational Therapy degree at the University of Magallanes, which includes items such as Inclusive Language, Splitting (female and male pairs), use of gender-neutral expressions, use of gender-neutral pronouns and determinants, as well as presence and/or absence of specific topics of gender perspective and sexual diversity. The checklist considered for its elaboration, an instrument designed by Arcos et al. (2006), enriched and updated by the review of inclusive language manuals (Guichard, 2018; Kalinowski et al., 2020; Barrera Linares, 2022). It was subsequently applied in a pilot form to a small number of documents and reviewed by experts in gender and diversity.

Interview

Semi-structured interview aimed at teachers of the degree, questions are considered in relation to the approach to the topics presented above and how they experience them in the classroom and at the University. The method of conducting semi-structured interviews is considered, as a guide for the topics to be discussed, (Ríos Martínez, 2019).

Focus group

Aimed at students of Occupational Therapy, with the participation of students from the different levels of the degree.

Participants and selection of participants

Teachers and students of the occupational therapy program at the University of Magallanes participated, with an intentional selection for both groups. Considering four occupational therapy teachers, two men and two women, who belong to different areas of academic training.

Regarding the selection of students for focus groups, belonging to the LGBTIQA+ community and also cisgender students, incorporating 8 students from different educational levels.

Inclusion criteria for teachers:

1. Being a teacher of the program.

2. Having a minimum of 3 years of seniority.

3. Teaching classes in at least two levels of the program.

Inclusion criteria for the students:

1. Being a student of the program.

2. Being enrolled between the first and the fifth year of the program

Data collection

First phase

Review of the curriculum and course programs of the Occupational Therapy degree at the University of Magallanes. The curriculum document was reviewed as well as 23 subjects proportionally considering those taught between the 1st and 4th year. Institutional subjects were excluded to focus on those designed by the career. For this, a previously prepared comparison guideline was used in order to analyze the presence of inclusive language and the incorporation of topics from the perspective of gender and sexual diversity, as well as the existence of stereotypes or other forms of discrimination.

Second phase

The interviews were applied to teachers, individually, taking between 30 to 45 minutes. These were recorded and included the signing of informed consent. A focus group was also held with the participation of 8 students, lasting approximately one hour, where questions were asked about the hidden curriculum of the Occupational Therapy degree at the University of Magallanes, focusing on the experiences of students in academic activities. Participation in the focus group was through an intentional call after the signing of informed consent by students.

Once the information was collected, an analysis of the qualitative data was done using the software Atlas ti, version 9, which is a program developed at the Technical University of Berlin to segment data into units of meaning. The data is added and the program codes according to the previously designed scheme (Hernández Sampieri et al., 2014). Based on the responses obtained, both in the interviews with teachers and in the focus group conducted with students, different answers were found regarding the gender perspective and sexual diversity in the formal and hidden curriculum of the occupational therapy degree. This data was coded and analyzed by the research team, based on the content. For the analysis of the information regarding the study plan and subjects of the Occupational Therapy degree, the percentages obtained in the comparison guideline were considered, thereby determining the existence or not of the gender perspective and sexual diversity in the formal curriculum and analyzing its form of presentation.

Ethical considerations

This research complies with all current regulations, both national, such as Law 19,628, which deals with the protection of privacy, more specifically with sensitive data, and also the international regulations, such as the Declaration of Helsinki, on universal ethical aspects in research. The research was approved by the scientific ethics committee of the University of Magallanes. Teachers and students signed an informed consent in which the above is specified.

Presentation of results and analysis

It is necessary to mention that the occupational therapist degree began in our region in 2003, under the auspices of the now Faculty of Health Sciences, and in this period of 20 years of life it has contributed to the training of almost 300 professionals, who perform successfully at national and regional levels. Currently there is a permanent teaching staff of 9 full-time occupational therapists and 50 part-timers. In addition to teachers who teach some subjects permanently, there are also those who come from other regions. The annual average of admissions is approximately 30 students. The program has current national and international accreditation.

Both the study plans and the subject programs are periodically reviewed and updated by the Department's curriculum committee.

Below, we will present the review of the study plan and subject programs according to guidelines developed by the Occupational Therapy Department.

Results of the document review of the 2020 Curriculum

Regarding the language, the use of the masculine is preferred, there is no typographic strategies, splitting, use of the vowel "e" or other alternative strategies. However, there is a significant presence of gender-neutral expressions, genderless pronouns and determiners, the replacement of man with human being or person and the elimination of articles with neutral nouns.

In relation to the gender perspective and sexual and gender diversity, these are not made explicit in the document, there is only an allusion to concepts such as diversity, inclusion associated with dignity and human rights.

Regarding the use of inclusive language in the degree programs (Figure 1), a total of 23 degree programs were reviewed, in which it is observed that there is a majority effort to be inclusive, with the most commonly used strategies being the use of neutral expressions and impersonal forms with 73.9% each, secondly the strategy of eliminating articles and replacing them with neutral nouns, thirdly the typographic strategy a/o and genderless determiners with 30.4% and then genderless pronouns with 21.7%. In no program the use of the vowel e is observed, some of them use @ as another form of inclusive language whit 8.7% of the total, and splitting in only one of them, 4.3%. Even considering the above, it can be seen that more than 50% of the programs preferentially use the generic masculine in their writing, particularly those associated with the most clinical areas of the degree; on the contrary, where more efforts are seen to incorporate inclusive language are those more transversal subjects of the degree.

Regarding the consideration of the gender perspective and sexual diversity in degree programs (Figure 2), of the 23 subjects reviewed, it can be seen that almost all of them, 22 of them, that is, 95.7%, include female authors in their bibliography, the majority of them being classic and international, and to a lesser extent contemporary and national, or Latin American.

60.9% of the programs incorporate and explain the concepts of diversity and inclusion and 17.4% refer to the differential effect of the topics in relation to sexual and gender diversity, while only 1 program (4.3%) refers to differential effect by gender. On the other hand, there are only 2 programs, 8.7% that explain the gender perspective in their approach.

Results of interviews carried out with teachers and a focus group of students of the degree

First, the tables characterizing the participants, teachers for the interviews (Table 1), and students for the focus group (Table 2), are presented.

The results of both processes are then presented, grouping the narratives according to the topics addressed, according to the conceptual map (Figure 3).

Manifestations in the curriculum

Level of knowledge in relation to gender and sexual diversity

Both groups, teachers and students, state that there has been a positive evolution in the degree based on the level of knowledge and incorporation of inclusive language and other techniques for the inclusion of the gender perspective and sexual diversity. Mention is even made on several occasions of the impact of the University's Gender and Equity Department and the incorporation of sexual diversity teachers in specific talks and training in the degree. These trainings in the health area are extremely important and necessary to promote a safe space for both teachers and the student community. The Gender Department together with the degree has coordinated actions with foundations and organizations to train the university community.

Based on the focus group carried out among students, knowledge and perceptions in relation to sexual diversity and the gender perspective were explored. The results revealed that, in general, students showed to have a medium level of knowledge on these topics, which suggests a growing awareness in the student community about sexual diversity and gender perspective.

... These are terms that go hand in hand and with respect to diversity, each one has their identity. One decides to express themselves, decide how to show themselves in society, and each one has the right to do so and we are all different. So, issues of diversity, have to go hand in hand with the respect that we must have towards people in the face of this expression of each one of us (S2).

However, despite this level of knowledge, confusion arises regarding the understanding and application of some terms associated with these topics, which suggests the need for greater clarity and education in this regard.

... Gender is like the sex of the person. I mean, from what is said, as well as perspective is like what sex or whatever... I don't know how to explain it....the person defines him/herself (S3).

According to the shared perceptions of students, it is highlighted that there is a small group of teachers in the Occupational Therapy program who have significant knowledge in relation to these concepts.

...In the course of my degree, I can name or count on one hand, better said, the teachers who have a broader and more comprehensive view, they have a base, a training, they have carried out studies, they have completed master's degrees and they have these doctorates that specialize and who have studied diversity and try to incorporate them into the program (S8).

Observation reveals that there are teachers who not only have a high level of knowledge according to the topics, but who also stand out for implementing pedagogical strategies that promote the inclusion of sexual diversity and the gender perspective in their classes. However, concern arises when noting that this small group of teachers seems to be the exception rather than the norm. A greater number of students perceives that the majority of the teaching staff lacks solid knowledge on these topics and, therefore, does not incorporate inclusive strategies in their teaching methods.

This can be seen in the interviews with teachers, where a disparity in the level of knowledge is observed, evidencing, for example, confusion between terms of gender and sexuality.

There is not only masculine or feminine, but there are others. I think that depending on how people feel, they work according to their physiological condition, if they are female or male (T1).

Even those who handle the different topics very well.

The gender perspective is a way of looking, of incorporating oneself towards a certain topic. In this case, when we talk about gender perspective, we refer to this social construction that gender means and how we position ourselves on this topic (T2).

The levels of knowledge identified in the interviews, as will be seen below, are associated with greater interest in training and trying to incorporate inclusive strategies into their pedagogics activities.

Strategies for incorporating of gender perspective

In some of the interviews that were conducted, there is an interest in having more training, assigning this responsibility for training to the university, generally stating that there is a positive change in this issue.

I think that the university should train teachers, already in these same awareness-raising sessions, training and even with some type of certification, I think it is necessary so that it becomes less and less of an "issue", so that it becomes more and more normalized... (T1).

There are teachers who use strategies in the classroom, regarding the bibliography.

I also try to include female authors, to include women as examples, and also to demonstrate within being a woman as a teacher the faculties or strengths that we can have as well, not only in what I speak, but also in what I do (T4).

In the community area is where the gender perspective strategies are taught the most, however, in areas such as mental, physical, and child-youth health, which are considered more clinical areas, no greater progress is observed.

...There are still not many women who publish books in that line, that is, books on biomechanics for example, the tendency is for men to prevail over women (T1).

Students in the focus group highlighted that, with respect to the gender perspective, this is not included in the classroom of some areas of Occupational Therapy

Always the same, that is, in anatomy, always the man, in examples of the man. Female teachers do give examples, but of women. It seems that we pigeonhole ourselves a lot in that and they are the same teachers who always tell us and give those examples as more diverse in certain things. But the others don't, they don't do anything. That's always the case. I think that they are already used to that. And that is why the teachers who adapt more to the changes are those who always name not only the masculine (S6).

According to this, there are students who perceive a significant disparity in terms of the knowledge that their teachers have regarding these relevant topics. This gap is shown in different ways, one of them is the lack of adequate pedagogical tools to address the gender perspective.

The results highlight that there are teachers who approach subjects with a transversal approach, oriented towards the community and the social, who are more willing to incorporate inclusive strategies in their teaching methods. Teachers who seem to be more aware of the importance of integrating the gender perspective in the content of their subjects, contributing to a more holistic learning. In contrast, a lower presence of inclusive strategies is perceived by teachers who teach subjects in the clinical area. These areas, which generally focus on more technical and specific aspects, seem to present a greater challenge in terms of the integration of content and strategies related to these topics, or are associated with teachers who have less training and/or interest in these.

Strategies for incorporating of sexual diversity perspectives

In the interviews directed to teachers, there is evidence that in general they show interest in training and education on sexual diversity and what this subject entails

...I think that we have to reinforce and do a more guided and more permanent training, because the subject itself brings you closer to all these topics, but because we are concerned about people, then we are always approaching everything that can interrupt their proper functioning (T4).

As a result of the interest in training, there are those who incorporate strategies in their bibliography generating their inclusion.

...Last year we innovated in a first-year subject, where we talked about occupations, we talked about sexuality as an occupation (T4).

Regarding inclusive language within the classroom, the interviews showed that there is interest in including it.

...So, from the writing point of view, when I communicate with my students in writing, I try to speak to all of them, not just to some (T2).

Seeking to implement inclusive strategies also in terms of the treatment of each student.

...Generally, with new students it is to ask, I am always interested in knowing the social name of each person (T3).

The use of these strategies arises from different origins, whether it be interest, the experiences they have had and from the areas in which each teacher develops. According to the perceptions of each student, a tendency is observed in the application of inclusive strategies by teachers, being more frequent in those who teach transversal subjects in the branch of community Occupational Therapy

...In my year, yes, it has been seen. I don't remember exactly which specific branch it is, but it was with the teachers of the community area. One day it took like three, four classes just on sexual diversity, how each of the topics are differentiated, he showed us the gingerbread cookie. Which, honestly, many of us didn't even know (E4).

Compared to teachers who teach subjects in clinical areas.

...There are teachers who focus more on their area, effectively, the physical area that is based on medicine, but in mental health, that should be broader, more comprehensive... (S6).

The results highlight teachers who show interest in these topics by including them in their bibliographies and within inclusive language, however, students highlight that there are differences in the different courses taught by the degree, since there are teachers who are not interested in including sexual diversity in their subjects and even show rejection of openness in certain topics.

Awareness process for change

In the context of continuous learning on subjects related to sexual and gender diversity, there are teachers who have responded proactively to the growing implicit demand from the student community. With the incorporation or visibility of more people who belong to sexual diversity in the degree, a significant commitment has been observed on the part of teachers to make relevant adjustments.

I have had troubles for not knowing, for not understanding, for example, when we talk about feminism in general, I think I have had to take books, literature, take action on the matter, also look in more consolidated sources, information about what feminism is, what gender identity means, what the sexual characteristics of the person are, I think it is something that is super unknown, that is still super taboo and finally you find out and you are nourished by what you see on social networks, but nothing so formative (T3).

These changes are aimed at updating the use of language and the way people are treated, fully recognizing and respecting the rights they possess.

We always talked about human rights, our profession talks about human rights, but the gender perspective itself was not involved, it was not an issue. So, it has been a learning process today. I try to incorporate it, from oral and written communication, trying to include and not exclude (T2).

Sensitivity towards the specific needs of sexual diversity has become an essential component of education, prompting educators to adapt their practices to reflect an inclusive and respectful environment. This approach has become essential due to the diversification of the student community, with more people bringing unique perspectives from their diverse sexual identities.

From my perspective, I don't want to make anyone feel bad and I don't want to make mistakes, and I've told my students that in any situation, please talk to me or discuss it, and I've seen that there are other professors whose paradigm is the valid one, and I know that these changes exist and I recognize that it has been difficult for me because I am in this paradigmatic clash, but I am making the effort with scripts to speak and there are other people at the University who are not (T1).

In relation to the above, a need for training, on the part of teachers and students, and consequently, the debate on the obligatory nature of this arises.

...That they require us, because they have trained us, but perhaps that they force us to move from our paradigms, because in the long run, as I was saying, I have an inner struggle with certain topics that cost me to incorporate.... in the modification we will make in the study program, I am forced to do it, so that makes me move more (T1).

In the field of Occupational Therapy, the importance of keeping updated is a fundamental principle for professionals who seek to offer effective and person-centered interventions. In this dynamic process of updating, the gender perspective and attention to sexual diversities emerge as essential elements that must be incorporated by those who practice and teaching in Occupational Therapy.

Discrimination

In the university context, worrying manifestations of discrimination are evident, according to reports collected from teachers and students. The problem covers different dimensions, from discrimination linked to social name.

For example, the other day I was talking to a colleague and she had a trans girl and she still appeared with the name on her ID card, and her social name was not there, and this is already a network throughout the University, but there is still a process that has not been completely resolved, so a professor keeps calling her by her old name, and the professor tells her that she cannot call her whatever she wants because it is not on paper, so there is still this lack of awareness in other departments, in other careers... it costs more (T1).

To unfavorable attitudes towards teachers of sexual diversity and mentions of discrimination based on ethnic origin.

...Yes, because it also has to be not only for the students, but also for the teachers. Because when someone comes who has something other than... that is, identifies himself differently than how he looks, so to speak, they don't know how to act or they disrespect him by calling him "he" when it's "she" (T3).

These experiences, narrated by members of the academic community, underline the urgent need to address these problems to promote an inclusive university environment, where diversity is valued and respected.

According to the focus group carried out among students, an experience was revealed that highlights the persistence of discriminatory situations in the university environment, a reality that affects the student community in different ways. In this case, discrimination was not limited to the classroom, but was manifested in an uncomfortable way in the university library.

...For example, in the library I had a super uncomfortable situation at the beginning of the semester, I went with a classmate, and he was listed as she in the system, not as he, so he said to her, give me your ID, he already gave her his ID and said to her, but here in the system you appear as such and such a name, when he was male, not female, and he reiterated many times that he was wrong and that he was a she, not a he, so these are uncomfortable situations for both parties, for the person who is experiencing the situation as a victim, if you can say that, and the person who is being the victimizer, like I don't know if accusing or harassing in that way (S2).

This incident illustrates the urgent need to be able to implement significant changes in order to address and guarantee inclusion and respect for sexual diversity.

Discussion

Through the review of 23 subject programs in the Occupational Therapy degree, the presence of a gender perspective and sexual diversity in the formal curriculum is evident. This presence is observed in the use of language, incorporation in some subjects of specific topics such as gender, sexual diversity and concepts of inclusion and diversity, as well as a high presence of female authors in the bibliography, mainly. The above is mostly seen in subjects in the Community and Occupational Science training line. From this perspective, as Abregú and Molina suggest, it is important to consider that the topics of gender perspective and sexual diversity cannot be pigeonholed or encapsulated in specific curricular spaces that belong to an area of knowledge related to the community (Abregú& Molina, 2021).

A widespread effort to adopt inclusive language is highlighted, through strategies such as the use of neutral expressions and impersonal forms. However, it is observed that more than 50% of the programs still persist in using the generic masculine as preferred, especially in clinical areas. This trend is attributed to the lack of knowledge and interest in the elaboration of written and spoken discourse with a gender perspective in the programs, pointing out the need to strengthen training in this aspect to achieve a more effective integration in Occupational Therapy training. Regarding the above, the study carried out in Argentina, in the Occupational Therapy program at the Universidad Abierta Interamericana, suggests, as found in our study, that knowledge about the gender perspective and sexual diversity is found within community Occupational Therapy, and loses impact within clinical areas (Abregú& Molina, 2021).

Regarding the gender perspective and sexual diversity, a high presence of female authors is observed in the bibliography (95.7%), mainly corresponding to classical occupational therapists, and from countries such as the USA or Europe, making it necessary to incorporate more national or Latin American authors who are also contemporary.

Based on interviews with teachers and students, the presence of manifestations regarding the gender perspective and sexual diversity in the hidden curriculum of the Occupational Therapy degree is evident, mentioning different strategies used by a minority of teachers who show greater sensitivity to these issues, observing that, although it does not include the entire academic community, they have affected the academic training.

Although in general there are attempts to approach paradigm shifts in the training processes of the degree, it is inevitable to realize the impact of the hidden curriculum, mainly perceived in the discourse of teachers and students, which allows us to observe how some beliefs, forms of teaching and relationships are maintained, which replicate sexist styles rooted in the culture, against which they mention that they perceive and/or make attempts to go against the current, these not being yet sufficient. In this sense, Luz Maceira Ochoa (2005) suggests that in every educational institution there is a hidden gender curriculum or the so-called invisible gender pedagogy (Acaso, 2012, as cited in Castellanos& Sánchez, 2020), which includes codes, norms, relationship styles and symbolic resources that maintain messages of discrimination, and undervaluation of women, both in relation to the perception of their attitudes or abilities towards learning, and in the structuring of relationships with authority and between peers (Maceira Ochoa, 2005).

In line with our research, the results of a study carried out at the University of La Coruña, Spain, show an increase in the interest of the student community regarding the gender perspective, as well as greater training. It also points out that applying the gender perspective in teaching requires greater teacher training (Canosa Domínguez et al., 2020).

Regarding the incorporation of specific topics of sexual and gender diversity within the Occupational Therapy curriculum at the University of Magallanes, this is not present in the formal curriculum through its study plan or subject programs, however, in practice they are considered units within some subjects and training for teachers and students.

It is important to highlight that this proactive movement arises from the personal initiative and participation in training of this minority group of teachers mentioned above. However, although there is a clear interest by them in participating in these trainings and learning about issues of gender perspective and sexual diversity, a significant gap has been identified in terms of follow-up and effective implementation of the acquired strategies.

With regard to scientific evidence, no background was found regarding the inclusion of these specific topics in the occupational therapy degree. However, a study carried out at the National University of General Sarmiento, Argentina, shows the need to formally incorporate these topics into subject programs, carrying out strategies such as the implementation of a course entitled "TransForming the programs" to include and mainstream the gender perspective in university programs, starting with degrees in the social sciences and humanities, responding to the multiple ways in which inequality and gender violence manifest themselves in the university community (Attardo et al., 2020), being an important step to reduce the main barriers to inclusive education and learning, such as discrimination, inequalities and social exclusion (Sánchez Teruel& Robles Bello, 2013).

Based on the above, it becomes important to add specific content on gender perspective and sexual diversity in the occupational therapy curriculum.

A worrying discovery in the framework of the research was the presence of discrimination that affects students within the university. This discrimination ranges from that linked to the use of social name, which, although formally declared and applied in the administrative aspect, unfavorable attitudes towards students and teachers of sexual diversity are still observed, to mentions of discrimination based on ethnic origin. It is particularly alarming that even the university library is not exempt from this phenomenon. The existence of these discriminatory situations underlines the urgency of addressing these problems to ensure an academic environment that fosters equity, inclusion and respect. As Morrison points out, discriminatory speech based on skin color, sex, gender expression, functional diversity, etc. cannot be allowed, when occupational therapy is clear in its bases, foundations and reason for existing, it must strongly condemn hate speech (Morrison& Silva, 2018).

Conclusion

In conclusion, the research on the presence of gender perspective and sexual diversity in the occupational therapy curriculum reveals a series of significant findings. Despite notable efforts to adopt inclusive language in the course programs, a lack of knowledge is identified in the elaboration of written and spoken discourse with a gender and diversity perspective, especially in clinical areas where the preferential use of the masculine persists. Although there is a high presence of female authors in the bibliography, the need to improve the explicit incorporation of diversity and inclusion concepts is highlighted, with a differential focus on gender and sexual diversity in the subjects, particularly in more clinical areas.

The research also shows that knowledge about gender perspective and sexual diversity tends to concentrate in community occupational therapy, losing impact in clinical areas. Interviews with teachers and students reveal manifestations in the hidden curriculum, underlining the importance of a more explicit and extensive approach in the training of Occupational Therapy professionals.

Although there is a growing interest among students and teachers in these topics, there is a need for further teacher training and education to effectively apply the gender and diversity perspective in documents such as study plans and course programs, as well as teaching strategies. It is perceived that the proactive movement of some teachers at the University of Magallanes has promoted the inclusion of units on sexual and gender diversity, but there is a gap in the effective implementation of the acquired strategies.

A negative aspect highlighted in the research is the discrimination experienced by students within the university, which contradicts the fundamental values of occupational therapy and the principles of respect and human rights. Making these problems visible is proposed as the first step to finding solutions that strengthen the proposed inclusion strategies.

In response to these findings, it is concluded that it is critical to add specific content on gender perspective and sexual diversity explicitly in the occupational therapy curriculum. Furthermore, the importance of demonstrating the effective implementation of these strategies to share learning and promote a more inclusive and respectful academic environment is highlighted.

References

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Author's Contributions

Oskarina Palma Candia: conception of the text, methodological guide, analysis, writing and revision of the information. Camila Alarcón Aguero: conducting interviews and analyzing the information. Camilla Briones Pino: conducting interviews and analyzing the information. Valentina Gutiérrez Márquez: leading focus group, analysis and writing. Fani Haro Vera: Leading focus group, analysis and writing. José Hernández Douglas: literature review and drafting of discussion and conclusions. All authors approved the final version of the text.

Funding Source

This work is derived from a larger study "Gender perspectives and sexual diversities in the technical and professional degrees of the University of Magallanes" Eterovic C., Silvana E., Palma O. and Venegas L., (in press), which analyzes all the degrees of the University, which received funding obtained through an internal project competition of the University of Magallanes, Chile.

Corresponding author

Oskarina Palma Candia e-mail: [email protected]

Section editor

Profa. Dra. Daniela Edelvis Testa