Rainbow Health Network: An LGBT Health and Wellbeing Community Development Model

1. Rainbow Health Network: An LGBT Health and Wellbeing Community Development Model Phyllis Waugh & Nick Mul� Moderator: Nancy Nicol World Outgames 2nd International Conference on LGBT Human Rights Copenhagen, Denmark July 27, 2009

2. Agenda Moderator�s Introduction Socio-Political Context LGBT Health & Wellbeing Issues in Toronto About RHN RHN Model RHN Achievements & Challenges Discussion

3. Socio-Political Context National � LGBs recognized in Canadian Human Rights Act and Charter of Rights and Freedoms Provincial/Territorial � �Sexual orientation� included in Human Rights Codes across Canada Local � City of Toronto fully recognizes LGBTs in its Anti-Racism, Access and Equity Policy Variance in LGBT Rights � Trans populations not recognized federally or provincially/territorially, except for the Northwest Territories Recognition in human rights legislation does not necessarily translate into acceptance

4. Socio-Political Context 2 Lack of LGBT recognition in health & wellbeing policy, funding & programming General discomfort regarding issues of sex, sexuality and gender variance in policy, funding & services world LGBTs not seen as a culturally distinct group Research methodological limitations for evidence, due to the �closet� Systemic heterosexism and homophobia Systemic forms of oppression that marginalize LGBTs

5. Socio-Political Context 3 National: Canadian Rainbow Health Coalition (CRHC) Provincial: Coalition for Lesbian and Gay Rights in Ontario (CLGRO) Local: Rainbow Health Network (RHN)

6. LGBT Health & Wellbeing Issues in Toronto Toronto Demographics Toronto pop. 2.5 million, GTA 5 million LGBT = 10%? Toronto 250,000; GTA 500,000 All income levels, classes, dis/abilities All racial and ethnic backgrounds; immigrants & refugees Toronto is one of the world�s most multicultural cities Half of pop. born outside Canada. 43% �visible minority� First Nations (Aboriginal) pop. approx. 12,000 Francophones approx. 43,000 Earliest incidents of homophobia in Canada: European colonizers meet First Nations Two-Spirited people - a respected social and spiritual role that combines male & female spirits.

7. LGBT Health & Wellbeing Issues in Toronto 2 Toronto is a centre that draws LGBT people from all over the world It has specialized services � Sherbourne Health Centre, The 519 Community Centre Large teaching hospitals Still, LGBT people face discrimination Nationwide - Lesbians & gay men have unmet health needs twice as high as heterosexuals, bisexuals even higher, trans are the highest.

8. LGBT Health & Wellbeing Issues in Toronto 3 Access to healthcare is affected by homo/bi/lesbo/transphobia Avoidance of healthcare visits, lack of preventive screening Provider misinformation; lack of knowledge LGBT patients may face multiple types of discrimination Discrimination affects health Stress related diseases, anxiety, depression, suicidality Violence, assault, threats � greatest for trans people Substance use is higher among LGBT people Tobacco use, Toronto � LGBT 36%; heterosexuals 15%  Myth that lesbians are not exposed to HPV virus and don�t need Pap tests Higher risk factors for some cancers- Lung, Breast, Cervical, Anal Greater unmet health needs among bisexuals than lesbians or gay men; greatest among transpeople Myth that lesbians are not exposed to HPV virus and don�t need Pap tests Higher risk factors for some cancers- Lung, Breast, Cervical, Anal Greater unmet health needs among bisexuals than lesbians or gay men; greatest among transpeople

9. LGBT Health & Wellbeing Issues in Toronto 4 Trans People: Few doctors/clinics provide hormones, monitoring Discrimination in employment, services, families and communities - very high rates of depression, suicidality, and substance abuse Sex reassignment surgery (SRS) reinstated in Ontario - limited access to approval process or pre-operative care RHN is active in establishing the new protocol

10. LGBT Health & Wellbeing Issues in Toronto 5 Families, Youth, Seniors: �Lesbian baby boom� � specialized services created Mainstream family services alienating - fertility clinics, adoption agencies, day care, schools LGBT youth and children of LGBT parents face discrimination in schools � 80% of bullying is related to gender identity and sexual orientation Seniors - avoid homecare, day programs and nursing homes. 3 Toronto Long Term Care homes have an LGBT program

11. About RHN - Vision Our vision is the optimal health and wellness of people and communities of all gender identities and sexual orientations, as well as intersex people. This includes � and is not limited to - Lesbian, Gay, Bisexual, Intersex, Two-Spirit, Transsexual, Transgender, Queer and Questioning people and our allies.

12. About RHN - Mission The Rainbow Health Network is a catalyst and a resource for activities promoting the health and wellness of people of diverse sexual orientations and gender identities, in Toronto and beyond*. We are committed to equity-based, community-based, anti-racism and anti-oppression values. We strive for representation of the full diversity of our communities and commit to building partnerships to achieve this goal. *As a volunteer network with limited resources, our activities are focused primarily in Toronto, and our advocacy and lobbying primarily in Ontario. However, since issues of sexual and gender diversity cross all boundaries, we are open to sharing information and support across provincial and national borders.

13. About RHN - Objectives Networking Advocacy Equity Education

14. RHN Model Spawned from CLGRO to address recommendations in Project Affirmation�s final report Systems Failure Grassroots network of LGBT-identified or friendly individuals that work or are recipients in the health care and social service fields Volunteer driven

15. RHN Model 2 Committee Structure: Steering Committee (chair, secretary, treasurer, reps for networking, education, advocacy, and equity, two members at large) Committees: Anti-Racism, Anti-Oppression & Education Committee Political Action Committee Trans Health Lobby Group Monthly Meetings

16. RHN Model 3 Listserv Website � www.rainbowhealthnetwork.ca Projects: Education Tools (Toolkit, Training for Change) Northern Partnerships Professional Associations Social Determinants of Health (paper, brochure) Smoking Cessation Public Education Mainstream Health Care and Social Service Professionals Students Funding Training Fees - Grants (projects) Consultations Donations

17. RHN Achievements & Challenges Networking: Challenge- volunteer driven, lack of funding What�s been on the listserv recently? Ex. of what types of info are shared

18. RHN Achievements & Challenges 2 Advocacy: Sex Reassignment Surgery re-listed Trans Human Rights Campaign Rainbow Health Ontario Province wide, Community Outreach Team RHO website and databases Conference: March 31 � April 2, 2010

19. RHN Achievements & Challenges 3 Equity: RHN�s entry point is sexual and gender diversity Challenge � LGBT people experience marginalization for many reasons - such as sex, class, ability, race, etc. Need an integrated anti-oppression framework Anti-Racism Report (2005/06) Achievement � Anti-Racism / Anti-Oppression (ARAO) Committee / Initiative Need more formal structure for accountability Anti-Racism Report (2005/06) lack of representation within RHN leadership need to increase knowledge on how identities intersect, change & develop discomfort around issues of �race� need for self-education Achievement � Anti-Racism / Anti-Oppression (ARAO) cttee / initiative � outreach, internal workshops Working on more formal structure for accountability � policies, Equity policy � while keeping an informal, open atmosphere Anti-Racism Report (2005/06) lack of representation within RHN leadership need to increase knowledge on how identities intersect, change & develop discomfort around issues of �race� need for self-education Achievement � Anti-Racism / Anti-Oppression (ARAO) cttee / initiative � outreach, internal workshops Working on more formal structure for accountability � policies, Equity policy � while keeping an informal, open atmosphere

20. RHN Achievements & Challenges 4 Equity: Challenge - Some key ethnocultural org�s in Toronto that engage with LGBT issues are funded for HIV/AIDS work. RHN needs to find a balance.

21. RHN Achievements & Challenges 5 Education: Equity work and education were merged Public forums � emphasis on intersections of oppressions Toolkit, workshops in hospitals & agencies Challenges limited RHN resources limits education work resistance from institutions � attitudes and funding

22. RHN Achievements & Challenges 6 Achievement � �Training for Change: An Anti-Oppression Framework� Based on input from trainers representing diverse communities Key findings: Anti-oppression work can lack an intersectional analysis Language and concepts can be interpreted differently and create additional barriers Lived experience of the trainer is a factor

23. Conclusion / Discussion We�d like to hear from you about how a model like this could be appropriate in your area. Some questions to consider: In the era of the HIV/AIDS epidemic, how do we address broader health and wellbeing issues of LGBT people? How can LGBT health professionals be accountable to our own communities, when larger systems may not be supportive? How can LGBT service users voice their concerns about health care and social services? In the era of the HIV/AIDS epidemic, how do we address broader health and wellbeing issues of LGBT people? Listserv& forums - bring people together Liaison among existing services in Toronto, ie SHC, 519, which were developed through long history of community advocacy Education within mainstream services How can LGBT health professionals be accountable to our own communities, when larger systems may not be supportive? Provider Education Develop allies within the systems Employee groups, ie, Mt. Sinai Hospital use opportunity of Pride marches, Pride week events � ie, UHN marched for the first time in 2009 How can LGBT service users voice their concerns about health care and social services? Advocacy groups, ex � THLG & Trans Human Rights Campaign Funding issue has 2 sides � more funding, can do more, but limits ability to advocate , lobby, protest, etc In the era of the HIV/AIDS epidemic, how do we address broader health and wellbeing issues of LGBT people? Listserv& forums - bring people together Liaison among existing services in Toronto, ie SHC, 519, which were developed through long history of community advocacy Education within mainstream services How can LGBT health professionals be accountable to our own communities, when larger systems may not be supportive? Provider Education Develop allies within the systems Employee groups, ie, Mt. Sinai Hospital use opportunity of Pride marches, Pride week events � ie, UHN marched for the first time in 2009 How can LGBT service users voice their concerns about health care and social services? Advocacy groups, ex � THLG & Trans Human Rights Campaign Funding issue has 2 sides � more funding, can do more, but limits ability to advocate , lobby, protest, etc

24. Contact Us Phyllis Waugh � LHIN7@rainbowhealthontario.ca Nick Mul� � nickmule@yorku.ca Nancy Nicol � nnicol@yorku.ca Rainbow Health Network www.RainbowHealthNetwork.ca Rainbow Health Ontario www.RainbowHealthOntario.ca Canadian Rainbow Health Coalition www.RainbowHealth.ca Coalition for Lesbian and Gay Rights in Ontario www.CLGRO.org