Decolonizing Gender, Sexuality & Mental Health

How has trauma inflicted upon my people through Residential Schools and the Sixties Scoop impacted our views around gender and sexuality? How has religion changed how we view relationships? How has language extraction impacted the ways we talk about gender and sex? These are questions I ask myself when I think about why Indigenous people have disproportionately high rates of sexually transmitted infections, including HIV/AIDS. Indigenous communities can also be very transphobic and homophobic, due to the impacts of colonialism and the pervasiveness of homophobia and transphobia elsewhere in society.

The biggest underlying issue that is affecting us is stigma and how that continues to impact the mental health of Indigenous people across Canada.

I am a Saulteaux-Cree First Nations person who identifies as Two Spirit, Queer and Trans. I grew up in an urbanized community, and spent a big part of my life within the Friendship Centre movement surrounded by other Indigenous people. I feel a great deal of privilege being trans and queer while growing up in an urban community because I have had a significant amount of access to resources and space to explore my identity compared to my Two Spirit & Indigenous LGBTQ+ friends in the North.

I have access to knowledge and information that has allowed me to expand my knowledge on sexuality and gender. I have had access to spaces that are affirming for my identity and I know where to meet other LGBTQ+ people. I have choices in which communities I choose to spend my time with. I know how to access Hormonal Transition Therapy and know that my transitioning costs can be covered under Indian Status. I have been able to learn and advocate more about sexuality and gender without the fear of being outed. Because of my access to my resources, I’m not afraid to be myself. Because of feeling comfortable with my identity, I am comfortable with my body and exploring and learning how to talk about sexual health. It’s also been easier for me to destigmatize my own views around sexuality and gender and to even pursue a career in sexual health. I have learned how to navigate the health system with ease because of this. I know where to go to for a routine sexual health check-up, and I wouldn’t be afraid if I was diagnosed with an STI. I know what contraception methods are available to me under Indian status and how to get Plan B for cheap. I know how to access counselling services for sexual assault, and also where and how to access an abortion if I ever need one. I have had access to a basic understanding of sexual health because of the public school curriculums I have been a part of. I think these are things that many of us take for granted.

For the past year and a half, I’ve been working alongside many different Indigenous communities to broaden their understanding of sexual health, gender and sexuality. I’ve also worked with many Indigenous youth leaders who do the same work. Storytelling and sharing circles, where participants sit in a circle to share stories without interruption, are ways that Indigenous people share knowledge with each other and have become foundational to my work. It is important for me to put time into listening to the various experiences that Indigenous people go through when it comes to sexual health, sexuality and gender. It was through this process I learned more concretely about how the violent history of colonialism has impacted many Indigenous people across Canada, and how many Indigenous people still hold stigma around sexual health, sexuality and gender. I have met many Indigenous people who have shared their stories with me and they have allowed me to share pieces of them with others for the purpose of starting these conversations.

The stories I have heard many times in multiple different ways from various people have had the same theme: ​fear​.​ ​From fear around coming out to their families and communities due to homophobia and transphobia, to fear of being gossiped about in a small community after being spotted by a community member at the sexual health clinic. Another person shared how an HIV/AIDs service provider breached confidentiality of a client’s HIV status, and how it impacted their life. The most dangerous part of these stories is stigma and how it silences people and results in negative mental health impacts for those experiencing these incidents.

Indigenous people who identify as Two Spirit and LGBTQ+, as well as Indigenous people post-diagnosis, are more likely to experience suicidal thoughts at some point in their lives. Conversations around sexual health, sexuality and gender can be difficult for many Indigenous people because these words have potential to hold a lot of power, and also possess a history of trauma. This is because of the legacies that systems like Residential School and the Sixties Scoop have created.

Indian Residential Schools were government-sponsored Christian-based schools to assimilate Indigenous children into European culture. Many children were forcibly taken from their families to attend and were punished for speaking their native language or practicing their culture. The educational curriculum was inadequate, and many Indigenous children were sexually abused throughout Residential School.

The Sixties Scoop was a government-run practice of forcibly taking Indigenous children throughout the sixties and placing them into foster homes and adoption. Being separated from your community, culture and language is traumatizing for Indigenous children, and we have seen the effects that these systems have created for Indigenous people currently. When Indigenous children were separated from their culture and language, they were also separated from teachings around the fluidity of gender and their roles and because many Indigenous people now strongly believe within the Christian faith, it has also stigmatized our views around sexuality. It was through these systems that talking about sexual health, sexuality and gender has become shameful to talk about, as well as traumatic.

How then do we approach the stigma of sexual health, sexuality and gender? I have learned through my work that storytelling and sharing circles are a very powerful way for Indigenous people to share their stories of misconception, pain, trauma and stigma while also reconnecting to culture. Sharing circles have potential to be healing and can take a trauma-informed approach. They are a crucial way to help Indigenous people learn and unpack the ways that we view gender and sexuality, and to help destigmatize conversations about healthy sexuality, sexual health and harm reduction. It’s through these conversations that we will begin to turn shame into resilience.

Sexual and mental health: Two sides of the same coin

By Laurie Edmiston

The attendees at the 2016 Canadian Mental Health Association (CMHA) conference, Mental Health for All, were a new audience for CATIE. This was the first time CATIE was invited to attend as an exhibitor to a mental health conference. Most people who stopped by our booth had never heard about us, but after chatting to one mental health worker from the Niagara region, she said: “I wish I had known about you guys six months ago.”

This woman had shared a story about an HIV-positive client who was having sex without a condom. I asked, “Have you heard about treatment as prevention? Undetectable viral loads or pre-exposure prophalysis (PreP)?” She was somewhat familiar with these forms of HIV prevention, but only after researching these topics on her own.

Another person stopped by, this time from correctional services. He picked up some client brochures on HIV basics and safer injecting. He didn’t realize that CATIE offered so many printed resources on harm reduction and that some were created with prisons in mind.

Both of these service providers didn’t know that CATIE provides all frontline workers with information on HIV and hepatitis C, whether they work in the field or not. We could have saved them a lot of time by giving them the information their clients need.

These are just two encounters from one meeting that took place last year in Toronto. But these stories highlight the importance of sexual health organizations working with mental health organizations to increase knowledge around health and harm reduction.

Physical health + mental health = overall health

Physical health and mental health are two important aspects of our overall health. These two branches interconnect and contribute to a person’s overall well-being. HIV and mental health also intersect and should not exist in silos. In order to improve the lives of people living with HIV or at risk of HIV, we need to partner with people working in mental health so that both sectors can share expertise and build skills and capacity.

This is what we know.

Mental health conditions are risk factors for HIV transmission. There is a correlation between poor mental health and engaging in risky behaviours. Some people use drugs, sex or alcohol as a coping mechanism for stress, anxiety or low self-esteem. Using substances or sex as ways of coping can lead to dependency. When a person is dependent on something, their judgement can be impaired when having sex or injecting drugs, putting them at risk of HIV or hepatitis C.

Mental health conditions can affect the other health outcomes of people living with HIV. Sometimes an HIV diagnosis can provoke mental health conditions due to the fear or the isolation of coping with a new illness. Other people living with HIV may feel lonely or depressed throughout periods of their life because of the stigma and discrimination they might encounter. Studies show that people living with HIV are more likely to be diagnosed with one of several mental health conditions. We also know that HIV, the disease itself, can impact the brain due to its effects on the central nervous system. All of the above affect quality of life.

People living with HIV who are on treatment can live long lives and they can be happy and healthy too, but only if they are connected to the proper care and services. We must help them receive this care and make sure they do not fall through the cracks. Research also shows that poor mental health also makes it harder for some HIV-positive people to stay adherent to treatment, find HIV care and stay in care.

What can we do as service providers?

The HIV and mental health sectors should come together and collaborate on a number of initiatives that would improve the health of people living with HIV or at risk of HIV. Here’s just a short list:

  1. Screen HIV-positive people for mental health conditions and offer mental health referrals to people in need. Integrating mental health services into HIV care can increase access to support and decrease the stigma associated with HIV and mental health.
  2. Develop skills-building workshops that promote positive mental health. CATIE, for example, offers a workshop for frontline workers called “HIV and Emotional Health”. This workshop stresses the importance of building healthy relationships, developing positive self-esteem, and adopting sex-positive and harm reduction approaches. Teaching clients these skills leads to resiliency and improved overall health.
  3. Use peer-based approaches to provide information on HIV and to build positive mental health. CATIE and a national group of healthcare providers developed the resource Practice Guidelines for Peer Health Navigation for People Living with HIV, after it became evident that peers serve as role models, helping HIV-positive people develop self-esteem and a positive outlook. It has also been shown that peer health navigation allows people living with HIV to better navigate healthcare systems, putting them in touch with the services they need to thrive.
  4. Provide training for staff to learn more about HIV, hepatitis C, mental health and how manage these conditions. This could be as simple as providing resources, tools and courses designed for frontline staff working with people living with HIV. CATIE has range of materials available for order, free of charge. We also offer online courses through eduCATIE.ca.

It’s our job as community health program planners, social workers, corrections officers, public health nurses and doctors, to work together to make sure that people at risk of HIV or living with HIV get the treatment and support they need, whether that be antiretrovirals, cognitive behavioural therapy, opioid substitution therapy or a peer-led discussion group. Let’s work together to make that happen!

For more information on HIV and emotional wellness, contact CATIE: call our toll-free line at 1-800-263-1638, browse the website at www.catie.ca or email us at [email protected]. CATIE offers information in English and French.

Recommended resources:

Let’s Eliminate Stigma around Sexually Transmitted Infections!

Despite ongoing public health efforts and the fact that sexually transmitted infections (STIs) are preventable and treatable, new infections continue to occur and, in fact, are on the rise. Between 2010 and 2015, there was an 85.6% increase in the reported rate of syphilis, a 65.4% increase in the reported rate of gonorrhea and a 16.7% increase in the reported rate of chlamydia.

Despite ongoing public education efforts to address perceptions associated with STIs, stigma persists. Stigma can lead to negative mental health outcomes, feelings of shame, isolation and negative self-image. These feelings may also act as barriers that prevent people from getting tested or accessing the care, treatment and support they need.

People who have an STI may experience or perceive stigma, particularly in health care settings. It is important that we, as health professionals, be aware of and avoid potential sources of stigma. Keep the following in mind:

  1. Consider your biases: Reflect on your personal attitudes and beliefs. Don’t make assumptions about your patient’s gender, sexual orientation or sexuality.
  2. Educate yourself on how to talk about sexual health: Be conscious of your language. Create open and respectful dialogues with your patients when talking about sexual health and demonstrate an understanding of their diverse needs.
  3. Show compassion: Burnout and compassion fatigue are real concerns among health professionals who see patient after patient and may begin to focus on the illness ahead of the person. The simple act of displaying empathy for those struggling with an STI can go a long way in making patients feel valued and respected.

Sexual health is integral to our overall health and well-being. During Sexual and Reproductive Health Awareness Week, I encourage you to think about actions you can take to help reduce stigma and support positive sexual health for all Canadians.

[PODCAST] Mind Your “Business”

Press Release: SRH Week Campaign Connects the Dots between Mental Health and Sexual Health

For immediate release

From 12-16 February, Action Canada for Sexual Health and Rights (Action Canada) is proud to host Sexual and Reproductive Health Awareness Week (SRH Week), an annual nation-wide campaign that promotes sexual and reproductive health in Canada. This year’s theme is Mind your “Business” and focuses on the intersections between mental health and sexual health.

While campaigns around de-stigmatizing sexual health or mental health are on the rise, these rarely address how they intersect. This year’s SRH Week campaign was created in consultation with the Canadian Mental Health Association (CMHA) and aims to raise awareness on the many links that are often left out.

For this year’s campaign, Montreal artist Edith Boucher designed a poster, which is free to order on the SRH Week website. More than 4,000 posters have already been mailed out to healthcare providers, public health agencies, schools and non-for-profit organizations across every province and territory in Canada.

SRH Week will launch with a blog from Canada’s Chief Public Health Officer Dr. Theresa Tam on the stigma around sexually transmitted infections and its impact on mental health. Other features include a podcast discussing mental and sexual health with a registered nurse and a health care advocate, a Public Health Agency of Canada webinar for health care providers, a series of blogposts written by community-based organizations and advocates, local events across the country, and a printable handbook for healthcare professionals looking to provide stigma-free mental and sexual health care.

“The handbook includes information and tips for healthcare providers on how to talk about sexual health and mental health with their patients,” says Prasad, Executive Director for Action Canada for Sexual Health and Rights. “Stigma, shame, embarrassment, and fear often prevent patients from talking about their mental health and their sexual health, let alone both.”

The guidebook provides communication tips to help healthcare providers foster trust and openness so that their patients/clients can feel comfortable talking about issues related to their mental and sexual health.

“Everyone is entitled to positive and affirming health care that routinely and proactively meets their mental health and sexual health needs and all the ways in which they connect,” adds Prasad “This is one way we can help fill the gap in access to positive and affirming health care.”

To learn more about Sexual and Reproductive Awareness Week, the connections between sexual health and mental health, and to order free posters, visit www.srhweek.ca

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MEDIA CONTACT
Ani Colekessian
613-241-4474 ext 7
[email protected]

Manitoba SRH Week Events!

In Winnipeg:

Click here to download PDF poster with full list of Winnipeg events

All week long SERC will be releasing self care tips each day on our social media! follow along on Twitter, Facebook, or Instagram.

Thursday Feb 8
9:00-10:00 pm The Sex Files Radio Show on CKUW 95.9 FM – the topic is Sexual Health and Mental Wellbeing: The Mind Body Connection

Monday Feb 12
We will deliver heart shaped boxes filled with condoms, candy & positive messages that have been decorated by Teen Talk’s Peer Support Program youth volunteers to Winnipeg`s Teen Clinics
&
Online release of a new SERC video ‘Facing Stigma in Our Own Words’ based on the experiences of African newcomer communities in Winnipeg

Tuesday Feb 13
11:45-1:00 pm at 200-226 Osborne Street North, `Talking With Youth About Mental & Sexual Health: a Lunch & Learn for Service Providers’ presented by Teen Talk

Wednesday Feb 14
11:00am-2:00 pm second floor, Portage Place shopping centre visit our booth with Nine Circles & pick up some safer sex supplies & Digital Valentine release on SERC’s social media created by Winnipeg artist, Kristen Aleida & Blog release, written by Maree Rodriguez, long time Teen Talk Peer Support Program youth volunteer and mental health advocate

Friday Feb 16
Release of ‘Sex Ed, Broken Hearts & Mental Health blog’ written by SERC staff and released by Action Canada

In Brandon

Click here to download PDF poster with full list of Brandon events

All week long Brandon’s  Sexual Health  Committee will be handing out safer sex kits to local bars and lounges

Wednesday Feb 14
12:00-3:00 PM visit our booth at Brandon University for safer sex supplies

Friday Feb 16
12:00-1:00PM at SERC Brandon, Unit C, 1700 Pacific Avenue
‘Risk Reduction for Safer Sex Toy Use’ Lunch and Learn. Please register by emailing [email protected]-more information here! 

Stay tuned to SERC website for the latest updates on all of our SRH Week events!

Newfoundland and Labrador SRH Week Events!

To bring awareness and celebrate the work of Planned Parenthood – Newfoundland and Labrador Sexual Health Centre, they will be hosting a number of events from Monday, Feb.12th-Friday, Feb.16th.

Click here for exciting events, news, contests and games around the city of St. John’s! 

On MONDAY (Feb. 12th): Planned Parenthood Open House!!! Come to the centre, 203 Merrymeeting Road, at 5:00PM-7:30pm for cake, information and contests! We have some awesome prizes this year!

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!