SRH Week 2018 is just around the corner!

This year,  Sexual and Reproductive Health Awareness Week (SRH Week)  will take place from February 12-16 with the theme: Mind Your “Business”

We want to spark conversations that help make the connection between sexual health and mental health clear and have been consulting with the Canadian Mental Health Association (CMHA) to prepare for SRH Week 2018.

In addition to posters designed by Montreal artist Edith Boucher, SRH Week 2018 will feature a series of blogposts written by community-based organizations, a resource for health care providers on non-stigmatizing comprehensive care that addresses the many connections between mental and sexual/reproductive health, podcasts, a webinar, and more!

We’ll be on Facebook and Twitter too! Find us @srhweek or download our social media kit at www.srhweek.ca (available soon!).

The new campaign and material will be available on www.srhweek.ca as of February 12.

Can’t wait until then? The site and all our exciting tools from past campaigns are available year-round with reliable, easy to access, up-to-date and comprehensive bilingual information on sexual and reproductive health. Visit www.srhweek.ca to see for yourself!

Of course, any campaign needs strong voices to really make a difference. Help promote sexual and reproductive health this SRH Week by displaying the posters, following @SRHweek on Facebook and Twitter, visiting www.srhweek.ca and helping to spread the word!

Want free posters? No problem! If you would like to order copies of the poster, visit www.srhweek.ca and fill out the poster order form. We’ll be happy to send you more at no charge.

Thanks for your support in making the connection between mental and sexual/reproductive health!

It’s time to Mind Your “Business”!

Opt BC SRH Week Breakfast Fundraiser

Join Options for Sexual Health Thursday February 15th at the Marriott Hotel in Downtown Vancouver for the 5th annual SRH Week breakfast fundraiser. We will dine, network and celebrate with our incredible host Kathryn Gretsinger and honour our 2018 Sexual Health Champion Dr Gina Ogilvie. Dr Ogilvie is the Canada Research Chair in Global Control of HPV-related Disease at UBC, and Senior Advisor and Assistant Director of the Women’s Health Research Institute at our own BC Women’s Hospital. Dr. Ogilvie and her colleagues are working toward the global eradication of cervical cancer and they are closer than you might think!

BC’s Planned Parenthood needs your support to continue our work in clinics, schools and across the world wide web.

Click here to buy your tickets today!

Public Health Agency of Canada Webinar: SRH Week 2018

This year, SRH Week will take place from February 12-18 with the theme: Mind Your “Business”. Hosted by Action Canada, the campaign provides resources for health care providers to have open conversations with their patients and provide affirming and non-stigmatizing care at the intersections of mental health and sexual / reproductive health. The campaign will also see the launch of several articles by community experts working at these intersections, a podcast-style recorded interview between a health care provider and patient advocate, and much more! The webinar will introduce the different components of the campaign, as well as walk participants through some quick tips to provide quality care at the intersections of mental and sexual/reproductive health.

Thursday, January 25, 2018 1:00 pm – 2:00pm
Eastern Standard Time (New York, GMT-05:00)

Click here to register today!

SRH Week 2018 Sneak Peek!

The Action Canada for Sexual Health and Rights team is gearing up for our annual Sexual and Reproductive Health Awareness campaign (SRH Week)! SRH Week is a promotional and social media campaign designed to help raise awareness around sexual and reproductive health and highlight resources developed to help improve community health.

This year, the campaign will focus on the intersections between mental health and sexual health, and all the complex ways in which sexual and mental wellness are connected. To this end, we are creating a campaign titled Mind Your “Business” to foster further dialogue around how these two important aspects of health interconnect.

This is important because:

  • In all aspects of our lives, we deserve to be treated as complex full individuals. This means recognizing mental and sexual/reproductive health and wellness as integral to our overall well-being.
  • Mental health and sexual/reproductive health are both important parts of our overall health and do not exist in silos. There is a significant amount of research supporting the many links between mental and sexual/reproductive health.
  • We are entitled to positive and affirming health care that routinely and proactively meets our mental health and sexual/reproductive health needs and all the ways in which they connect.

The campaign will run from February 12th until February 16th, 2018 and will feature:

  • A series of blogposts written by community-based organizations whose work centres on mental and sexual/reproductive health;
  • A resource for health care providers on how to provide care that acknowledges the relationships between mental and sexual wellness in a non-stigmatizing and comprehensive way;
  • A podcast with a health care provider and client discussing what comprehensive and non-stigmatizing mental and sexual/reproductive health care can and should look like;
  • A poster designed by Montreal artist Edith Boucher;
  • A webinar for health care providers and advocates about the 2018 campaign, why it’s important and how to get involved.

All materials will go live on www.srhweek.ca on February 12, 2018. 2018 Posters will be mailed out before the holidays. If you haven’t received free posters in previous years, but would like to, please fill out this short order form.

2017 SRH Week Survey

We want to hear your feedback so we can keep improving our campaign!

Please complete our quick survey and let us know your thoughts (your answers will be anonymous).

Click here to complete the survey

Hey Doctor, why aren’t you prescribing the abortion pill?

The newly available abortion pill (Mifegymiso) is everywhere in the news these days. Based on all the media coverage, you would think the World Health Organization’s “gold-standard” would be widely available, but so far, only a few doctors seem to be offering it. What gives?

The drug is already available and used safely in over 60 countries, and is an effective way to terminate a pregnancy by using medication rather than surgery. It can be used early in a pregnancy (up to 7-weeks gestation in Canada) and is finally available on the Canadian market.

The thing is, many physicians and pharmacists who want to begin prescribing and stocking Mifegymiso don’t know where to locate the training or order the medication. Here’s a handy roadmap for all the doctors and pharmacists looking to provide medical abortion, but simply don’t know where to start.

Are you a physician?

You can access the training here. Click on “Accredited Medical Abortion Training Program” and then “Register Now.”  Fill out the form, and check your email for confirmation. Completing this course will make you eligible to be a Mifegymiso prescriber. Upon completion, you will be asked to enter your physician license number and be contacted by the manufacturer (Celopharma) to order and stock the medication.

Are you a pharmacist?

You can access the training here. Click on “Accredited Medical Abortion Training Program” and then “Register Now”. Fill out the form, and be sure to click the box that says “I am a Pharmacist.” Completing this course will make you eligible to stock Mifegymiso. Upon completion, you will be asked to enter your pharmacist license number and contacted by the manufacturer (Celopharma) to order and stock the medication.

Note: the non-accredited version of the training can also be selected if you do not require or wish to receive Continuing Medical Education credits. The accredited version costs $50.00 and you will receive a certificate upon completion. The non-accredited version is free. Anyone can take the non-accredited version but only practicing physicians and pharmacists will be contacted by Celopharma to order and stock the medication upon completion.

Completing the training will make physicians eligible to dispense Mifegymiso (and stock it, if they wish to do so at their clinics) and pharmacists eligible to dispense Mifegymiso to physicians. For physicians who do not wish to stock the medication at their clinics, or lack the existing infrastructure to do so, they will need to find the nearest clinic or pharmacy that is trained to dispense Mifegymiso and receive it from them.

Start the Conversation

Doctors and pharmacists have been slow to take the training. And those that have are largely existing abortion providers. This is a huge opportunity for existing providers and other physicians, like family doctors, to help close the gap in access to reproductive choice in Canada.

So let’s start the conversation! Ask questions – if you’re a health care provider, talk to your colleagues, if you’re a client/patient, talk to your providers. We’ve got a long way to go until all people in Canada truly have access to all of their pregnancy options but together, we can break down barriers.

Are you a health careprovider? Click here to download the SRH2017 handbook for quick tips on talking about abortion in a non-stigmatizing way.

 

 

Ready for some pillow talk? Open conversation is crucial

Action Canada for Sexual Health and Rights (Action Canada) Executive Director Sandeep Prasad talks to XFM’s Sarah Cowan about the 2017 SRH Week campaign, what it is and why it’s important.

8 Steps toward Quality Care for Northern Indigenous Youth

What does good, non-stigmatized sexual healthcare look like for northern and indigenous youth? This question has become very important to me.

I have had the great privilege of discussing this question at length with youth across the Northwest Territories, the Yukon and Nunavut as a program facilitator for FOXY (Fostering Open eXpression among Youth), an arts based sexual health program that was awarded the 2014 Arctic Inspiration Prize and has taken the north by storm with its revolutionary approach to talking with youth about sexual health, sexuality, and relationships.

The following eight answers are woven from an amalgamation of candid, opened, group discussions with northern and indigenous teens.

  1. Tell them you’re glad they are there

One of the most powerful things you can do to encourage youth to access healthcare, to ensure a positive experience, and to help them spread the word to others, is to welcome them and congratulate them on taking steps to care for themselves. For many, and especially for youth, feeling unwelcomed, or even being treated with neutrality, can be detrimentally off-putting. A warm welcome and a high five for being there really goes a long way.

  1. Confidentiality

When you live in a small town, it can help a lot to be assured that your relationship with your healthcare provider is confidential. Of course, be honest about any restrictions that apply, especially when caring for youth, but confidentiality is so important when it comes to sexual and reproductive health and reminding people that their information is safe is an excellent step to a successful visit.

  1. Be accessible

In the north, healthcare is not always accessible, so you need to be as accessible as possible. This may be the first time, or the first time in a long time that someone has chosen to or been able to access your services – be thorough.

  1. Listen

The number one beef teens have with healthcare providers is that they don’t listen! Whether we don’t think they can understand, or just think they don’t know how to make good decisions, not listening to them is a sure way to shut them down and put up a barrier that will be more difficult to overcome the next time they need to access the healthcare system. After all, they are the experts on themselves and I promise we are much more likely to underestimate them than we are to overestimate them.

  1. Honour language barriers

Recognizing that many northern indigenous youth do not speak English as a first language is important. It is equally as important to balance that knowledge with the reminder that having English as a second language does not denote intelligence or ability to comprehend a concept. People can understand if you can put things the right way.

  1. Don’t assume gender or sexuality

Heteronormativity is a major deterrent for our LGBTQ2+ youth in accessing healthcare. By not assuming a patient’s gender or sexuality you are helping to overcome stigmatization and ultimately provide superior, more thorough care.

  1. Be trauma and violence informed

There is a push in medical circles in Canada right now to become more trauma and violence informed. This can help to provide very crucial services to a wide demographic in a way that will maximize receptiveness and efficacy. There is much that can be done in recognizing violence and trauma and knowing how to shape medical visits when you are working with a patient who is dealing with such experiences.

  1. Set them up for next time

You don’t know who will be providing their care next visit. Remind them not to give up if their next experience is less than ideal and that a second opinion is available, and a responsible option if they don’t feel they receive the care they need.

We all contribute to the legacy of our time, and I do hope that we are moving towards better services for all, including our northern and indigenous youth residing in small, outlying communities. These eight steps can take practice to become second nature, but are worth the extra effort. When we remind them that they are worth it, they remind us right back.

 

 

 

 

 

 

More than Pronouns and Good Intentions: 5 Ways toward decent and affirming trans healthcare

In the past few years, trans rights and social policies that take trans lives into account have seen exponential growth. This is largely due to the decades-long work of trans people, especially those organizing for their safety and survival. Critical progress has been made under the leadership of trans women of colour, trans people doing sex work, and trans parents; however, these contributions are so often devalued and minimized. Thanks to the hard work of trans communities before us, we now have increased protections, more visibility, and service providers who are scrambling to meet our needs. This sense of urgency to engage with us is even more pronounced with sexual and reproductive wellness—an area of health where vulnerable parts of our bodies and selves come under scrutiny by cis (non-trans) society and where cis providers have much to learn about sexual and gender diversity.

There is a great deal of variation in how providers deliver trans healthcare. Thus, instead of looking at specific actions that providers can take (which can vary depending on context), here are 5 values-based perspectives to consider as a provider.

These perspectives can contribute to dignified and affirming healthcare experiences, whether it be primary or specialist care, sexual and reproductive health, or mental health services. Above all though, we hope anyone involved in trans health is looking to their own local community for meaningful engagement[1] and up-to-date information on health care needs.

Depathologize gender and sexuality

As of 2012, Gender Identity Disorder (GID) has been replaced by Gender Dysphoria in the DSM-V[2]. However, transgender people continue to be pathologized in a variety of ways. Depending on where we live, psychological assessments and psychotherapy are often prerequisites to hormones, surgeries, and identification papers. Sometimes we must also adhere to prescriptive gender presentations, report specific sexual orientations or hide sex practices to meet a provider’s requirements. These pathologizing practices and other negative experiences with providers are communicated from peer to peer and have an impact on how, when, and if we use available services. As a provider, being mindful of how underlying biases and choices can affect our anxiety and avoidance is critical to quality care.

Respect self-determination and bodily autonomy

We have the right to make our own health decisions. This right to choice includes which interventions, treatments, and medications we want to access. We also have the right to label our own bodies and functions based on what feels comfortable or least problematic to us. To this end, follow our lead when it comes to terminology. Also, in order to avoid assumptions, check-in with us about what words we like to use, what parts we have (or don’t), and how we use those parts. Only ask intimate questions when relevant to our care. Communication about physical examination is also essential. Consent is important before touching another person, and some trans people prefer not to have a health practitioner touch certain parts of them. Reminding trans people they have the right to refuse treatments or ask for a second opinion are some ways to encourage our autonomy.

Cultivate safety and trust

Have practices and policies that explicitly show that you value trans people’s privacy and confidentiality. Very rarely are trans people encouraged to establish boundaries based on what feels right to us. Our privacy requirements should be addressed, and early on. For example, in Ontario, physicians are entitled to assume they have their client’s implied consent to share personal health information with other providers in the client’s circle of care. Assuming implied consent in this situation could cause harm and damage trust. The ethics of sharing personal information about our transitions and how these stories are told needs to be discussed.

Having clear policies that are made available to everyone will help trans people navigate services better and decide if the limits of confidentiality are acceptable to them. Knowing who has access to our files, what information goes on record, and how these records are stored helps us build confidence in our providers. Included in this type of explanation would be any mention of our histories of “gendered” health care (e.g. pap smears, menstrual cycles, testicular discomfort), and, importantly, which names are on file and which names get called out in the waiting room. We have the right to receive accommodations and to be addressed by our actual names regardless of whether or not these names are also on our identification documents. Taking these steps can go a long way in creating a safe environment.

See the unique person in front of you

Recognize that trans people are a diverse, complex, and often contradictory population—like all communities. This includes the people who wrote this article, who most definitely were not elected to represent the whole trans population! Trans people, like all people, come with different life baggage, worldviews, bodies, spiritualities, class backgrounds, and relationship networks. We also have our own intra-community conflicts, challenges, and strengths. Keep this in mind and do your best to show flexibility when collaborating with trans people. There is no “right way” or “wrong way” to be trans, nor is there any test to prove or disprove one’s trans-ness. Each individual comes to trans-ness through a unique life path, with different struggles and successes along the way.

Support trans knowledge, leadership and empowerment

Recognize that trans people have historically been, and continue to be, over-studied, under-consulted, and dismissed for their trans-ness. There are many papers about experiences of discrimination, risk-taking, mental illness, suicidality[3], and oppression of trans people, but very few concerning sexual and reproductive wellness. There are even fewer by trans researchers and/or in collaboration with trans communities.

Trans people are the experts on their own health, and on trans health broadly speaking. We have been doing comparative analyses of surgeons, medications, side-effects, therapeutic approaches and aftercare for as long as we have been accessing these services. Given the huge number of obstacles we have faced, we have been creative and efficient in navigating complex, often hostile health services to attain our wellness goals and support each other. To only credit cis (non-trans) people for advances in trans health is to ignore a whole wealth of knowledge and best practices based on years of community development and information gathering. Encouraging trans leadership and trans knowledge development is not only ethically better, it is also a more efficient use of resources.

We are indebted to trans people who came before us, those who will come after us, and everyone else who contributes to the collective work of trans liberation. To everyone making efforts to encourage meaningful involvement of trans people in reproductive and other forms of health: thank you and keep going! The conversation is just getting started.


 

[1] Much of what we know about meaningful engagement comes from principles which emerged from the HIV movement. Please visit the Canadian Positive People Network (CPPN) for more information on movements led by and for HIV positive people, and their contribution to many spheres of health advocacy.

[2] For a global resource on trans health and information on history, check out “Trans Bodies, Trans Selves”, a book developed by and for trans people: http://transbodies.com/, which includes a fantastic chapter on sexual and reproductive health.

[3] Check out TransPulse research findings on access to health care in Ontario: http://transpulseproject.ca/research/

Hey doctor, I’m cheating on you

That’s right, you’re not the only one in my life. I know I am supposed to come to you, my family doctor, for any health issue but when it comes to my gay sex life I go to another clinic, a community-based sexual health clinic in downtown.

You are probably wondering why. Well, honestly, I’m not sure. I just don’t feel as welcomed as a gay man at your clinic as I feel at the other clinic. Don’t get me wrong, every one is nice and helpful, and I really appreciated the rainbow flag sticker that they put up last year. I also appreciated your reaction the first time I mentioned having a boyfriend. And when it comes to my blood pressure, my kidneys, my knees, and my heart you make me feel safe. However, I think that sex is missing in our relationship. That’s right, we barely talk about sex. I don’t know if it is because it makes you uncomfortable or maybe it makes me uncomfortable. Or maybe both. I’m not sure.

But I’m not the only one who is cheating on you. I know, I know, that should not be an excuse but you know what they say: two in distress makes sorrow less. One of my f***friends is married and his wife does not know that he has sex with men. He will not tell you because you are also his wife and his daughter’s family doctor. That’s why he goes to that other clinic. Then there’s my ex-boyfriend who comes from a town an hour and a half away from the city. His family is very conservative and they still don’t know he is gay. He doesn’t tell you -or the pharmacist- because he has cousins working everywhere in town. He would rather go all the way to the city to that other clinic and get his PrEP and his antidepressants from the pharmacy next-door. And then there’s my friend who hasn’t been in Canada for long. I think he told you he is gay. However, he still will not get tested with you. It helps him feel less anxious being anonymous. I guess is the fact that he would not be able to get the permanent residency if he got HIV. At the other clinic, he can get tested and counselled anonymously.

So, let me tell you how the other makes me feel. I have never really noticed if they have a rainbow flag but on their website, they have many photos of gay guys and it didn’t take me long to find the information I was looking for. And when I called, they asked upfront and without discomfort if I have sexual relationships with men. Then for getting an appointment they only asked for my first name, no ID number, no address, no details, no police background check! If that wasn’t enough they had so many availabilities mornings, evenings, and weekends, with or without an appointment. As soon as I get there, even if it is all the way to downtown, I feel welcomed. It feels less like a medical centre and more like a community one. The guys in the reception are gay and it doesn’t feel awkward telling them it burns when I pee. The forms that I fill are anonymous but are also adapted for my sexual orientation and my gender identity. In the waiting room, I’m not afraid of running into my homophobic neighbour that bullied me all high school. Also, I don’t feel like I’m the only one there having threesomes with my partner and there are plenty of reading materials with useful information[i] for me and my friends: “Primed: A Sex Guide for Trans Men into Men”, “Use Your Head When Giving It: Blow Job Tips”, “Drugs, Alcohol and Gay Men”, “ShoutOut Against Homophobia, Biphobia, Transphobia and Heterosexism”, “Vivre au positif”, “Hep C and Sex for Gay, Bi and Queer Men”, “Chicos como tú”, “BDSM Safer Kinky Sex”, “Guide pour les clients des travailleurs du sexe” and the local gay magazine.

If all that didn’t feel good enough… the sex talk I have had there with the nurse, the counsellor and the doctor has been fantastic! I feel they listen to me and that they are not only interested on getting bacteria off my system but that they are working with me to help have the sex I want. I can talk openly with them. They know I’m in an open relationship with my boyfriend, that he is HIV positive, that I don’t always use condoms, that my older brother doesn’t talk to me because I’m gay, that I have multiple sex partners, and that I have a foot fetish. Every time I leave the clinic I don’t feel ashamed or guilty, I feel liberated and motivated to take my health in hand.

I’m not sure we can work things out and start all over again. Can we stop assuming my friends and I are cisgender, heterosexual and monogamous? Can we broaden our definition of masculinity? Can we try getting past the morals and the stigma around sex? Can we make sure our written, verbal and non-verbal interactions from the first contact all the way to treatment and follow-ups are inclusive and judgement-free? Probably that will make my friends and I stop cheating. Or maybe not. In the end, decades and decades of stigma don’t go away so fast, so each one of us comes out of the closet if and when it feels right. But even if I keep cheating, you would have done everything in your power to make me feel welcomed and safe.


[i] You can get most of the materials listed in the article for free from www.orders.catie.ca