Advancing 2SLGBTQ+ Health Equity: 4 Bold Ideas for the LGBTQ2 Action Plan

This year, the federal government is consulting 2SLGBTQ+ communities and organizations to develop the first-ever federal LGBTQ2 Action Plan. This plan is intended to guide future federal leadership on 2SLGBTQ+ issues. As the consultations with communities continue, our team has identified 4 bold ideas that we believe are essential to an effective and ambitious LGBTQ2 Action Plan. These ideas are derived from our collective decades of experience in 2SLGBTQ+ organizations and advocacy, and our work with local, provincial and national 2SLGBTQ+ organizations. 

Before we explore our proposals, we want to acknowledge the progress our country has made over the past decade. There is no doubt in our minds that we have come a long way on 2SLGBTQ+ issues. From marriage equality to trans rights, we have made real progress. While we applaud that progressprogress that we firmly believe has been furthered under the leadership of the current governmentprogress isn’t easy, nor is it necessarily consistent. Despite big leaps forward and significant legislative and legal victories, the everyday realities of many 2SLGBTQ+ people in Canada continue to be shaped by homophobia and transphobia. Our communities continue to experience terrifying rates of poverty, homelessness, mental health issues, and blatant, violent discrimination. 

Our team has been advocating on 2SLGBTQ+ issues since before the turn of the millennium. We have proudly advocated for legislative change, because legislative changes do matter. But, today, in 2021, legislation alone is insufficient. We need bold policy proposals with the potential to deliver concrete, tangible change in the everyday experiences of 2SLGBTQ+ people. The LGBTQ2 Action Plan is a unique opportunity for our government to put in place the strategies, policies and financial resources necessary to make a real difference for 2SLGBTQ+ communities from coast to coast to coast. 

Our top 4 recommendations for bold federal leadership in the LGBTQ2 Action Plan are:

1. Core Funding for Organizations Offering 2SLGBTQ+ Community, Health, and Social Services

2SLGBTQ+ community, health and social service organizations provide essential services that protect and promote human rights. These organizations, whose services range from food security programs to support groups for parents of trans kids to counselling and mental health care, have been chronically underfunded by all levels of government. On shoestring budgets, these organizations are on the front lines responding to the multiple crises impacting 2SLGBTQ+ communities. 

2SLGBTQ+ communities are faced with terrifying rates of poverty, food insecurity, homelessness, employment discrimination and mental health problems. On top of all this, 2SLGBTQ+ people still face significant barriers accessing mainstream community, health, and social services. In moments of crisis, when 2SLGBTQ+ folks have nowhere else to go, they time and again turn to their local 2SLGBTQ+ community organizations. 

Ending discrimination against 2SLGBTQ+ communities, and addressing the health inequities faced by our communities, has to start with bolstering the essential services our communities depend upon. By committing at least 25 million a year to core funding for 2SLGBTQ+ community organizations, as called for by the Enchante Network, which represents over 120 pride centres and 2SLGBTQ+ service providers across Canada, the federal government can stabilize and strengthen 2SLGBTQ+ community organizations while enhancing their capacity to meet the needs of their communities. Imagine if instead of every 2SLGBTQ+ community organization scrambling to keep their staff employed, they could focus on public education, health promotion, and improving community wellness. 

If we’re genuine in our commitment to 2SLGBTQ+ inclusion in Canada, there’s no better way to move inclusion forward than core funding for 2SLGBTQ+ community organizations.

2. A National Strategy to End Conversion Therapy and Support Survivors

Conversion therapy, the traumatic and scientifically disproven practice of trying to make a 2SLGBTQ+ person straight and/or cisgender, is still a shockingly prevalent issue in Canada. Evidence from the Community-Based Research Centre (CBRC) indicates that “as many as one in five sexual minority men (gay, bisexual, trans, Two-Spirit and queer or “GBT2Q”) report having ever experienced sexual orientation, gender identity or gender expression change efforts (SOGIECE) – and of them, nearly 40 per cent (or as many as 47,000 GBT2Q men in Canada) have experienced conversion therapy”. Similarily, evidence from Trans Pulse Canada indicates that 11% of trans people have been subjected to conversion therapy, including a terrifying 8% of trans youth between the ages of 14 and 24 – a clear indication that, despite progress, conversion therapy persists, and continues to target vulnerable young people in Canada.

Conversion therapy is an insidious practice. While it continues to persist in the form many of us imagine, through electroshock therapies and ‘ex-gay’ camps, it has also adapted to better survive amidst evolving public opinion on 2SLGBTQ+ rights. Now, we have ‘therapies to reduce same-sex behaviours’ or ‘deal with unwanted same-sex attraction’ that, while more careful in their language, are no less disturbing, morally repulsive, and traumatic practices. In numerous forms, conversion therapy persists in Canada. 

In 2020, the federal government introduced a bill to ban conversion therapy in Canada. This legislation is absolutely essential to protecting 2SLGBTQ+ people from the horrific practice of conversion therapy but is not enough on its own. 

Through a national strategy to end conversion therapy and support survivors, the federal government can fund and implement programs, as called for by No Conversion Canada, to:

  1. in consultation with survivors 2SLGBTQ+ people, commit to a legislative review of the federal ban two years following Royal assent to identify if updates or amendments are required,
  2. support survivors coping with these traumatic experiences through funding to 2SLGBTQ+ community, health and social service organizations,
  3. educate faith leaders, educators, healthcare workers and social service providers on 2SLGBTQ+ affirming care as a preventative measure, and
  4. create reporting processes to identify and shut down organizations or individuals offering conversion therapy services.

3. A National Strategy on Universal & Accessible Trans Healthcare

Despite our collective pride in the universality and accessibility of public healthcare in Canada, provinces and territories have extremely inconsistent coverage of transition-related healthcare, and many jurisdictions do not cover services deemed medically necessary by the World Professional Association for Transgender Health (WPATH). 

Access to transition-related healthcare has a demonstrated positive impact on the mental health of trans people and alleviates the often-debilitating impact of gender dysphoria. While not all trans people desire or need access to transition-related healthcare, the option should always be available to them.

Currently, trans people in most provinces and territories have to pay for at least some transition-related healthcare costs out of pocket. While these costs vary, depending on what is or isn’t covered in a given province or territory, many trans people are forced to spend thousands of dollars for what should be publicly insured medical services. Trans people, who are significantly more likely to live in poverty or be low income, are often denied access to medically necessary healthcare because they simply can’t afford it. 

Ultimately, Canadian healthcare falls under provincial jurisdiction, but the federal government can and should play a leadership role and bring provinces to the table to deliver on universal transition-related healthcare. Many provinces and territories have been leaders in this spaceYukon recently updated their coverage policy to be the very best in Canada, and British Columbia has quite comprehensive coverage. If the federal government made transition-related healthcare a priority, as called for by advocates, and even committed some funding to make it happen, it could happen faster and easier than you would believe possible.

4. A National Training Program and Public Education Campaign on 2SLGBTQ+ Inclusion

Members of 2SLGBTQ+ communities continue to face bigotry and discrimination every day, ranging from street harassment to discriminatory experiences while accessing healthcare. As found by Trans Pulse Canada, 84% of trans people in Canada avoid at least one public space due to fears of discrimination or harassment, 12% of trans and non-binary folks have avoided going to the emergency room in the past year, despite needing care, and 45% of trans and non-binary folks report at least 1 unmet physical or mental health need. The Being Safe Being Me survey out of the University of British Columbia found that 70% of trans youth had experienced sexual harassment at some point in their lives, and two thirds of young trans folks (ages 14-18) had been physically threatened or injured in the past year. 

Despite social progress, negative, harmful and dangerous misconceptions about 2SLGBTQ+ people persist within the general public. These anti-2SLGBTQ+ beliefs directly result in violence in the lives of 2SLGBTQ+ people. 20-40% of homeless youth identify as 2SLGBTQ+, because their families, holding bigoted beliefs, ban them from their homes. Anti-2SLGBTQ+ perspectives perpetuate street harassment, which in turn puts the very lives of 2SLGBTQ+ people at risk. When our communities seek access to health or social services, we’re too often met with more discriminationfrom uneducated providers without the knowledge and tools to provide us with 2SLGBTQ+ inclusive care. 

Through a federally funded training program on 2SLGBTQ+ inclusion, the federal government can work with national professional associations to enhance the capacity of service providers across all sectors, and particularly within primary healthcare, housing services, and services for survivors of sexual violence, to provide inclusive care to 2SLGBTQ+ communities. 

Through coordinated public education campaigns, alongside funding for community-based education and outreach, the federal government can begin to address negative perspectives and attitudes about 2SLGBTQ+ communities and reduce the prevalence of anti-2SLGBTQ+ street harassment, familial rejection and other forms of violence.

Moving Forward on 2SLGBTQ+ Issues, Health, Rights and Safety

There has been clear progress on 2SLGBTQ+ issues in the past 5, 10, and 20 years. We have made significant, impactful strides towards inclusion. Nonetheless, our communities are still in crisis, and legislative protections have proven insufficient to dismantling the systemic oppression and inequity experienced by 2SLGBTQ+ people in Canada. Through these 4 bold policy proposals, the federal government can step more fully into a leadership role and work with 2SLGBTQ+ communities, provinces and territories, and other key stakeholders to drastically improve 2SLGBTQ+ rights, safety, wellness and inclusion across Canada.