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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.

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.