At the beginning of this month about 300 service providers, researchers and policy makers gathered in Toronto for a conference focused on improving LGBT health and wellness and increasing the capacity to deliver quality health care to LGBT communities. It was organized by Rainbow Health Ontario, a province-wide program funded by Ontario’s Ministry of Health and Long Term Care with a mandate to improve access to services and to promote the health of Ontario’s LGBT communities.
Topics covered a wide spectrum of LGBT health and wellness issues, from youth to seniors, gender identity, newcomers, mental health and addictions, HIV and more. For the past 30 years, so much of our communities’ efforts have been focused on HIV and AIDS that we were in danger of overlooking the myriad other health issues that impact us. This conference tried to rectify the balance.
While issues of HIV were not ignored, they were not covered as comprehensively as they are in HIV-specific conferences. This was okay, I thought, because many of the health issues affecting queer people apart from HIV need a forum such as this to educate, highlight research findings and advocate for positive change.
For me, the highlight of the conference was the keynote address by Anna Travers, the director of Rainbow Health Ontario, and a fellow social worker whom I’ve had the privilege of knowing for over 30 years. In her presentation, Anna took us on a quick tour of revolutionary change in LGBT health in Ontario over the past 45 years. In the space of half a long lifetime, she said, a great deal has changed, starting with legal victories that began to lay the ground work for us to be seen as legitimate citizens rather than criminals, people with an inherent mental disorder or people with a moral weakness.
“Having some human rights allowed us to organize ourselves and begin to address our unique needs but, like every other marginalized group, we had to organize services for ourselves.”
Anna (right) gave an example of this from her experience of volunteering in the early days of the Toronto Counselling Centre for Lesbians and Gays (an organization that is now part of a mainstream social services agency, Family Service Toronto, and known as David Kelley Services, after one of the original founders). At the centre, Anna told us, “professionally trained counsellors offered services in someone’s apartment using their bedroom as an office. Clients and counsellors alike used code names. In the 1980s, funders were very leery of LGBT groups; the CEO of the United Way stated that they would never, ever, support a gay agency. The message here is that we are very often still doing it ourselves, although allies are increasingly recognizing the need to reach out and to become inclusive.”
Much changed, of course, as a result of AIDS, when our communities joined forces to secure research funds, and appropriate testing and treatment resources.
There has been a major change in trans health issues too. “It’s only in the last five years”, Anna pointed out, “that Ontario’s gender identity clinic changed its protocols such that now 90% of all patients seeking medical treatment are approved. Before that, about 90% were deemed unsuitable for treatment”.
Anna then went on to outline how we are doing in Ontario today. “We have strong human rights and leadership by community activists that have resulted in progressive policies and leading practices. The Ontario government has invested in capacity building resources by funding organizations such as the Ontario HIV Treatment Network, The Ontario AIDS Network and Rainbow Health Ontario.” Yet, although services have been built by dedicated activists, there remain big gaps and challenges. Anna listed some of them:
- LGBT people are not counted in many of our national and local surveys. This perpetuates invisibility.
- .Lack of base-line studies to tell us how healthy we are compared to the general population.
- Funding for LGBT health research is hard to access unless it is linked to HIV.
- Health and social service providers receive little education on LGBT cultural safety and in providing clinically competent services.
- Modules on LGBT issues tend to be optional, delivered by a guest speaker or initiated by students.
- Core curricula of medicine, nursing, social work, psychology, etc. doesn’t include knowledge and skills in LGBT health and wellness.
- LGBT people are seldom invited to participate in needs assessments or planning activities.
- LGBT people are not often included in a wide variety of consultations like other population groups in terms of seniors health, mental health services, home care, tobacco, alcohol and drug use and family support programs.
- LGBT people are invisible in most mainstream health promotion issues (such as mental health and addictions, smoking, some cancers, body image, healthy weight and fitness) despite having significant levels of health disparities.
These are some of the issues we need to address, Anna said, in taking LGBT health to the next level. The conference provided a wonderful opportunity to do just that: to work together to change systems and increase capacity to deliver quality health care to our LGBT communities.