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Creating Safe Spaces for LGBTQ People
1. Safe and Inclusive Spaces for Sexual
and Gender Minority (LGBTQ) People
www.marnipanas.com
Marni Panas, BHAdmn, CCIP
2. Presenter Disclosure
ā¢ Presenterās Name: Marni Panas
ā¢ I have no current or past relationships with commercial
entities
ā¢ I have received an honorarium from CSHP-BC for this
learning activity
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3. Presenter Disclosure
ā¢ This program has received no financial or in-kind support
from any commercial or other organization
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6. Objectives
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ļ Describe the lived and learned realities of transgender and gender
diverse patients & clients
ļ Apply LGBTQ* terminology
ļ Identify the myths and misunderstandings about transgender people
ļ Develop skills in creating safe, supportive and nurturing environment
for people of a sexual or gender minority
ļ Develop skills in communicating with and about sexual and gender
minority people in a way that is respectful and meaningful
7. Why learn about gender diversity?
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ļ Many people who identify as a sexual or gender minority have important
needs and are entitled to receive appropriate services
ļ Canadian and Provincial Human Rights Acts protects individuals from
discrimination based on sexual orientation, gender identity and gender
expression
ļ As health care providers, we are required to respond respectfully and
effectively to provide a safe and welcoming place for ALL members of the
public and co-workers
ļ Increasing awareness of sexual and gender diversity can increase the
8. Why consider our own values?
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When we are unaware of
values & assumptions, they
can affect our work in ways
we are not even aware of.
17. Family Matters ā¦
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ļ LGBTQ young adults who reported high levels of family rejection during adolescents
were:
ļ 8.4 times more likely to report having attempted suicide
ļ 5.9 times more likely to report high levels of depression
ļ 3.4 times more likely to use illegal drugs, and
ļ 3.4 time more likely to report having engaged in unprotected sex
ļ Compared with peers from families that reported no or low levels of family
rejection.
Ryan, C., Huebner, D., Diaz, R.M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay
and bisexual young adults. Pediatrics, 123(1), 346-352.
18. Family Matters ā¦
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ļ Family acceptance helps:
ļ Protect against depression, suicidal behavior, and substance abuse
ļ Promote self-esteem, social support, and overall health
Ryan, C., Russell, S.T., Hueber, D.M., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young
adults. Journal of Child and Adolescent Psychiatric Nursing, 23(4), 205-213.
22. ā¢ 13% have been fired for being trans (+ 15% more fired but not
sure why)
ā¢ Though 44% of trans people have post secondary/or graduate
degree, medium income is $15,000/year (Bauer, 2012)
ā¢ 20% have been physically or sexually assaulted for being trans,
34% have been verbally threatened or harassed but not
assaulted
Social Context(Bauer 2015b)
23. ā¢ 60% have avoided public spaces for fear of harassment, 57%
avoided public washrooms
ā¢ 50% have depressive symptoms consistent with clinical
depression, 43% of trans people have attempted suicide (10%
within past year)
Social Context(Bauer 2015b)
24. ā¢ 10% of emergency room patients report having care stopped
or denied because they were trans
ā¢ 25% reported being belittled or ridiculed by emergency care
provider for being trans
ā¢ 20% have avoided the ED when they needed it
Experiences in Health Care(Bauer 2015b)
25. ā¢ Among those with family physicians 40% reported discriminatory
behaviour at least once. Experiences include:
ā¢ Refusal of care
ā¢ Refusal to examine specific body parts
ā¢ Being ridiculed
ā¢ Use of demeaning language
Experiences in Health Care(Bauer 2015b)
26. ā¢ Being āoutedā by using non-preferred name (ādeadā name) when addressing
patient, doing in front of other patients
ā¢ Health care providers refusing to use preferred name/pronouns
ā¢ Obvious ridicule or scorn from health care providers
ā¢ Stares/double takes
ā¢ Refusal of care, either on principle, or provider conveys they do not have the
knowledge / skills
Experiences in Health Care(Bauer 2015b)
27. ā¢ Invasive questions
ā¢ Unnecessary physical exams
ā¢ Binary forms and other paperwork
ā¢ Binary bathrooms
ā¢ Well-intentioned āotheringā (e.g. putting trans patients in private
room at the end of the hall)
Experiences in Health Care(Bauer 2015b)
29. Issues Related to Accessing Services
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A personās experience of stigma and discrimination
Less likely to access care
Negative health outcomes
Lived experience, not being LGBTQ creates the barriers
30. Issues Related to Accessing Services
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ā¢People who identify as being sexually diverse may be at higher risk for
ā¢heart disease
ā¢Obesity
ā¢mental health concerns
ā¢substance use
ā¢interpersonal violence
ā¢certain cancers
ā¢Are less likely to participate in health promotion activities such as
screening for cervical cancer.
32. Terms to Know
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Sex
ā¢ The legal identifier assigned at birth depending on what genitals the
child is born with
Gender
ā¢ Social and cultural expectations of roles and presentation
33. Terms to Know
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Sexual Orientation
ā¢ Describes an individual's enduring physical, romantic and/or emotional
attraction to another person.
ā¢ Gender identity and sexual orientation are not the same. Transgender
people may be straight, lesbian, gay, or bisexual. For example, a person
who transitions from male to female and is attracted solely to men
would identify as a straight woman.
34. Terms to Know
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Transgender
ā¢ An umbrella term for people whose gender identity and/or gender
expression differs from what is typically associated with the sex they
were assigned at birth.
ā¢ People under the transgender umbrella may describe themselves using
one or more of a wide variety of terms ā including transgender.
36. Terms to Know
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Gender Identity
ā¢ One's internal, deeply held sense of one's gender.
ā¢ For transgender people, their own internal gender identity does not
match the sex they were assigned at birth.
ā¢ Most people have a gender identity of man or woman (or boy or girl). For
some people, their gender identity does not fit neatly into one of those
two choices.
ā¢ Unlike gender expression gender identity is not visible to others.
37. Terms to Know
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Gender Expression
ā¢ External manifestations of gender, expressed through one's name,
pronouns, clothing, haircut, behavior, voice, or body characteristics.
Society identifies these cues as masculine and feminine, although what is
considered masculine and feminine changes over time and varies by
culture.
ā¢ Typically, transgender people seek to make their gender expression align
with their gender identity, rather than the sex they were assigned at birth.
38. What can we do?
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ā¢ Beware of your own body language, facial expression and tone of
voice
ā¢ Express a willingness to learn about the individualās needs
ā¢ Acknowledge and apologize for slip-ups
ā¢ Confidentiality: Disclosure of oneās sexuality or gender identity
should be the right of the individual
39. What can we do?
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ā¢ Confidentiality
ā¢ Promote open conversation; reinforce confidentiality
ā¢ Specify what information will be kept in a patient/employeeās record
and who has access to it (e.g., Fear of outing)
ā¢ Disclosure of oneās sexuality or gender identity should be the right of
the client
ā¢ Ask yourself, āwhy is the patient/client here today?ā Deal with the
issue, not the identity
40. What can we do?
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Instead of: Use:
Husband or wife spouse
Boyfriend or girlfriend partner
Mother or father parent
He or she They or preferred pronoun*
Male Nurse Nurse
Female Doctor Physician / Doctor
Manpower Workforce / Personnel
Chairman Chair / Chairperson
41. What can we do?
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ļ Gender neutral pronouns may include Ze, Per, Ne, Ve
ļ Reflect back the language/pronoun the patron / co-worker
uses
ļ Use open ended questions
(Only use Mr., Ms., Mrs., Sir, Madam if the patient says
they prefer it.)
42. What can we do?
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ā¢ Stand up for LGBTQ individuals when they are mistreated
ā¢ Reach out for education, resources & support if you feel you need
more understanding yourself
ā¢ Avoid making assumptions and generalizations
ā¢ Ask how you can be supportive
43. www.marnipanas.com
What can we do?
Create safe and inclusive environments:
ā¢ Gender-neutral bathrooms and family
bathrooms
ā¢ Images that are diverse and inclusive
ā¢ Queer literature in waiting areas
ā¢ Inclusive forms, questionnaires and
processes
ā¢ Rainbow Flag
44. My life in transition ā¦
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āTo be yourself in a world that is
constantly trying to make you
something else is the greatest
accomplishment.ā
- Ralph Waldo Emerson
45. References
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ā¢ Transgender People in Ontario, Canada: Statistics from the Trans
PULSE Project to Inform Human Rights Policy (2015).
ā¢ Journal of Child and Adolescent Psychiatric Nursing, Family 2010;
Acceptance in adolescence and the health of LGBT young adults:
23(4), 205-213.
46. Letās have a conversation ā¦
www.marnipanas.com
marni.panas@gmail.com
@marnipanas
www.marnipanas.com
Editor's Notes
We want the session to be learner focused, why are you here? What would you like to learn? This activity will ensure that everyone feels welcome and included.
We want the session to be learner focused, why are you here? What would you like to learn? This activity will ensure that everyone feels welcome and included.
We want the session to be learner focused, why are you here? What would you like to learn? This activity will ensure that everyone feels welcome and included.
We want the session to be learner focused, why are you here? What would you like to learn? This activity will ensure that everyone feels welcome and included.
This is what people are telling our system and what keeps coming out in the research.
If individual experience suggests there are service gaps to meeting these mandates, we have room for growth.
Keep in mind that providing good service to people who are, letās say, gay, doesnāt mean that we stop giving good service to someone who is straight. No one gets better serviceā¦
We want to make sure that everyone who walks into this building can feel like they are seen for who they are, that they can be part of accessing health care safely and receive good customer care.
Human Rights Act ā protects sexual orientation
Bill of Rights ā gender identity & expression
This is what people are telling our system and what keeps coming out in the research.
If individual experience suggests there are service gaps to meeting these mandates, we have room for growth.
Keep in mind that providing good service to people who are, letās say, gay, doesnāt mean that we stop giving good service to someone who is straight. No one gets better serviceā¦
We want to make sure that everyone who walks into this building can feel like they are seen for who they are, that they can be part of accessing health care safely and receive good customer care.
Human Rights Act ā protects sexual orientation
Bill of Rights ā gender identity & expression
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.
Whether this is a patron, co-worker, friend or family ā¦
Before we go much further into this conversation, letās take a moment to consider our own values about sexuality.
Your personal values are exactly that, personal.
We all work under a set of City of Edmonton values to guide us professionally.
We can not switch off our personal values at work, we are not value free, so there is an interplay between the two
We are not going to ask you to share, or change, any of your personal beliefs. Rather, letās have some personal reflection about what we feel and think so that we can consider how it could affect the service we provide.