LGBTQ individuals are as diverse as the general population in their experiences with health and well-being. Many of the social determinants of health, including income and education, impact LGBTQ individuals in a variety of ways; however, some determinants of health, such as social marginalization, uniformly impact the health and well-being of people in the LGBTQ community. The impact of these social determinants results in heightened levels of stress, putting LGBTQ individuals at an increased risk of particular health issues and contributing to the inequitable burden of poor health outcomes. LGBTQ status has been shown to impact a variety of health outcomes and behaviours including: mental health; substance use; tobacco use; sexual health; violence/safety; nutrition, fitness, and weight; reproductive health and parenting.
National, provincial and local data on the LGBTQ population is limited for many reasons including:
- The Census and the Canadian Community Health Survey (CCHS) only began collecting data on the LGBTQ population in 2001 and 2003, respectively. The questions asked do not pertain to sexual behaviour or gender identity.
- Underreporting of LGBTQ status occurs frequently, due to fear of disclosure.
- Many individuals with same-sex attraction or individuals that engage in same-sex behaviours do not identify as gay or bisexual.
- Data often excludes many subpopulations of people that might identify as LGBTQ
The most widely accepted statistic is that close to 10% of the general population identifies as LGBTQ; using population counts from the 2011 Census, that equates to approximately 26,500 people in Wellington-Dufferin-Guelph (WDG).
A two-part study was conducted on LGBTQ health services and supports locally. First, a community survey for self-identified LGBTQ individuals was conducted, which asked local individuals about their experiences with and perceptions of Wellington-Dufferin-Guelph Public Health (WDGPH). Second, in-depth interviews were conducted with service providers from LGBTQ-friendly/focused agencies, which asked about local health supports for LGBTQ individuals, barriers faced by these individuals when accessing services, and the role that Public Health could play in improving the health and well-being of LGBTQ individuals locally. Results from these studies suggest that Public Health is not yet considered an LGBTQ-friendly organization by clients, community partners, and local service providers.
Based on the findings from the study, it is recommended that actions to address the health disparities experienced by the LGBTQ population should involve a series of coordinated efforts which include policy changes, creating supportive environments, and developing personnel skills. As a starting point, it is recommended that WDGPH improve data collection on LGBTQ-identified individuals, increase visibility of LGBTQ individuals in health promotion strategies and materials, receive Positive Space training, and acquire and utilize additional LGBTQ resources.
Improved Local LGBTQ Data Collection
Collecting local data on the LGBTQ population will increase knowledge of the population and fill current data gaps. To achieve this, WDGPH could identify or create a brief questionnaire for collecting information on the LGBTQ population, in consultation with members of the LGBTQ community. These questions could be widely shared with Agency staff so that they could be added to any surveys that ask for demographic information. This would improve the understanding of the LGBTQ population with WDG. Additionally, a health status survey specific to the LGBTQ population could be undertaken.
Increased Visibility of LGBTQ Individuals in Health Promotion Strategies
Despite the impact of gender identity and sexual orientation on health and well-being, most health promotion strategies are not targeted or inclusive of the LGBTQ community. Informative and culturally-appropriate health promotion strategies and materials are needed for the LGBTQ community. This could involve including photos of queer-identified individuals in health promotion pamphlets, promoting LGBTQ-specific services locally, and ensuring inclusive language is used on the WDGPH webpage.
Agency-Wide Positive Space Training
“Positive Space” is a program that was initially developed by the University of Toronto in 1996. Since its inception, the concept of a Positive Space has spread to most Canadian universities, and increasingly, community-based organizations, such as public health units. An agency that is a Positive Space is one that is open, welcoming, and provides equitable access to people of all sexual and gender diversities (OPHA, 2011). Inclusive personnel policies and practices provide the framework to support a Positive Space. An additional component is staff understanding and awareness of the LGBTQ population which is achieved through staff training around the issues of sexual and gender diversity.
When an agency is a Positive Space, LGBTQ people know that they are entering an inclusive atmosphere that is a safe venue for questions and open discussion of sexual orientation and gender issues. They know that they will not be discriminated against on the basis of sexual orientation or gender diversity and they know that they will receive services with dignity and respect. This is particularly important in a healthcare setting (OPHA, 2011).
Within the WDG area, there are several organizations that could certify WDGPH as a Positive Space. The Positive Space Network of Halton (The Network) has the most comprehensive curriculum and the most experience in terms of certification of larger organizations including Halton Public Health. The Network recognizes the importance of providing a local perspective on LGBTQ issues and has suggested partnering with HIV/AIDS Resources & Community Health (ARCH) as a guest speaker. ARCH welcomes the idea of a cross-agency partnership in order to better suit the needs of WDGPH. The Network also recommends that all Agency forms and documentation be reviewed to ensure they are LGBTQ inclusive. In addition to this documentation review, changes to the physical environment of the Agency, such as the creation of gender neutral washrooms, is recommended.
Acquire and Utilize Additional LGBTQ Resources
It is recommended that the Agency acquire additional LGBTQ resources for use by staff and clients, such as pamphlets for distribution regarding LGBTQ-specific health issues (e.g., transgender hormone therapy, LGBTQ parenting, and insemination procedures), and community resources and support groups for LGBTQ youth, adults and seniors. Improved knowledge and resources of WDGPH employees would enhance the quality of care received by LGBTQ individuals and facilitating a more welcoming environment.