Improving Pathways to Health for LGBTQ Populations in Canada:

1. Improving Pathways to Health for LGBTQ Populations in Canada: An Intersectional Approach Jacquie Gahagan, Lorna Boschman, Clemon George, Daniel Pugh, Nate Lachowsky, Brian Condran

2. Speakers LornaBoschman, University of British Columbia ClemonGeorge, University of Ontario Institute of Technology NathanLachowsky, University of Guelph DanielPugh, Gay Men’s Sexual Health Alliance of Ontario Moderators: JacquieGahagan & BrianCondran, Dalhousie University

3. Background • Previous research indicates that LGBTQ populations are less likely to access health services (i.e., cancer screening). • Historically, greater emphasis on mental health &/or sexual health from a deficit model (i.e., mental health, addictions, HIV). • LGBTQ populations have worse health outcomes than their age-matched peers. • Need to realign public health approaches in research, policy & programming to improve pathways to health among LGBTQ populations • In keeping with public health core competencies (determinants of health).

4. Why are we here? • This panel draws on the expertise of researchers, advocates & educators working with sexual & gender minoritized populations (LGBTQ) with experience in public health research, policy & practice. • Each presenter will briefly speak about their own work in strengthening pathways to health & improving health outcomes among LGBTQ populations • How can we ensure public health approaches meet the needs of LGBTQ populations?

5. Learning Objectives • Define LGBTQ-specific public health issues and related health outcomes among participants. • To identify ways in which sexual and gender minority status may impact health outcomes beyond the domain of sexual health. • To explore intersectional approaches for incorporating LGBTQ pathways to health into public health, health promoting initiatives. • To develop multisectoral partnerships aimed at meeting the health needs and realities of LGBTQ populations through this national dialogue.

6. Agenda • Panel presentations (~8 minutes per speaker = ~32 minutes) • Small group discussion (connecting to your own work in health/public health ~30 min.) • Large group discussion (~30 min> • Suggestions on the way forward in improving pathways to health for LGBTQ populations

7. Cancer’s Margins • National study of LBT2Q adults who have been diagnosed with breast or gynecologic cancer • Study probes how knowledge is gathered to inform treatment decisions • In-depth interviews and Digital Storytelling data • 56 patient and 16 support person interviews to date

8. Cancer’s Margins • How can public health workers go beyond “inclusion” to incorporate capacity to mobilize, modify and distribute cancer health knowledge? • How can public health workers promote electronic patient records with information about gender identity and sexual orientation?

9. African Caribbean • Black Canadian youth and their parents face challenges in discussing sexual health, dating, relationships (and HIV); • Several intersecting factors augment these challenges such as: • Gender • Culture • Intergenerational shifts • Prominent role of parents in interventions

10. African Caribbean • How can public health workers support youth in their sexual health development without ignoring the role of Black parents? • How can public health workers support Black parents in the sexual health development of youth without being seen as disrespectful?

11. Emerging Research • Moving from “deficits” to “strengths” • Health outcomes • Expanding beyond sexual health • Physical, mental and social health • Incorporating new theory/frameworks • Life course • Minority stress • Researching for action • Sex Now: substance use/experience • Cruising Counts: online social-sexual circuits • Population-specific health information • Public Health Core Competencies

12. Emerging Research • What are the important principles of and approaches to conducting needs assessments / priority setting with LGBTQ+ communities? • How might we better collect data to appropriately document the experiences of LGBTQ+ individuals? How do we change these systems and processes? • How do we establish and nurture the necessary mulit-sectoral partnerships in order to deliver culturally appropriate public health initiatives to highly diverse LGBTQ+ communities?

13. The sexual, mental & emotional of gay men • HIV and STI rates continue to remain disproportionately high • Evidence of mental and emotional impacts are profound • “Syndemics” and the intersectional lives of gay men • Resilience: leveraging strengths and capacities • What is the Gay Men’s Sexual Health Alliance? • What is “Our Agenda”?

14. The sexual, mental & emotional of gay men • How might we define what a public health “priority” looks like for gay men in Canada? • How can we address the structural factors (beyond sexuality) that impact gay men? • How might we shift gay men’s health to something beyond “the knee to the navel”?

15. Here is the plan: *pick a speaker/topic of interest & sit together *pick a scribe to take some ‘high level’ notes from your group *pick a spokesperson to report back in the large group discussion Small group discussions (~30 minutes)

16. Large Group Discussion (~30 minute)

17. Way forward… • Additional suggestions in moving forward on improving pathways to health among LGBTQ populations in Canada?

18. Thank you!