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The Importance of Queer and Trans-Affirming Mental Health and Substance Use Support

Historically, LGBTQ people have not been made to feel comfortable to talk about their lives and experiences while accessing support in health care and social service settings. To this day, many people suffer from abuse, bullying, harassment and discrimination because they are LGBTQ-identified. This certainly also happens in health care settings. Existing services are not designed with LGBTQ people in mind and health care providers are not receiving the proper training to meet the needs of this population. In response, Faith and Tim started Pieces to Pathways (P2P), a peer-based harm reduction program for queer and trans folks.

P2P started as a conversation between Faith and Tim, two friends who met in recovery. The two got sober with the support of 12-Step programs,[1] and this lived experience as sober queer and trans people combined with their histories of grassroots community development inspired the development of the program.

Faith and Tim, who are vocal about their own experiences with addiction and recovery, would regularly get friends or mutual acquaintances sent their way when they struggled with substance use. They would meet with these individuals, often in coffee shops, to discuss their stories and share what had worked for them to get sober and stay sober. When it came time to make a referral to social or health services that were queer and trans affirming, Faith and Tim discovered that there were very few places they felt comfortable referring people to.

In the summer of 2014, Faith and Tim started P2P and in December 2014, they were successful in securing government funding from the Toronto Central LHIN (Local Health Integration Network) to conduct a community based needs assessment. By the end of March 2015, a full literature review analyzing 115 peer-reviewed articles was conducted, 28 different social service providers were interviewed, 640 LGBTQ youth were surveyed, and 5 focus groups were facilitated with 48 participants. The findings, compiled into a final report, echoed Faith and Tim’s experiences:

  • 65% of survey respondents said that provider and/or client orientation towards their LGBTQ identity negatively impacted their service use experiences.
  • Past year substance use prevalence rates among queer/trans youth in Toronto ranged from 1.19 to 57.2 times higher than those of the general Canadian population.
  • 37% of survey respondents would like to or were actively trying to reduce or eliminate their alcohol use.
  • 44% of survey respondents would like to or were actively trying to reduce or eliminate their drug use.

Many queer and trans youth use alcohol and drugs to cope with the daily oppression they face in their lives and many use substances just to survive. When this population thinks they might have a problem with their use, they are unsure if existing services will be able to meet their needs as an LGBTQ person. When this population actually goes to get help and access services, 2 out of 3 have a negative experience because of their queer and trans identity. Survey respondents reported not feeling safe disclosing their identity, not being accepted for their identity, and being actively mistreated by health care providers. This results in an unfortunate situation where queer and trans folks must either access services that may be harmful to them, or completely disengage with services altogether.

To respond to these realities, P2P was envisioned as a peer based program – with all frontline staff being queer and trans identified and having their own lived experiences with substance use and recovery, however defined by each individual. In this model, lived experience is used both as an intervention strategy and as a tool to build community for people that are facing similar struggles. The program is currently housed at Breakaway Addiction Services[2] and, as a harm reduction program, offers 1-to-1 support through case management, hosts 3 community drop-in nights and co-facilitates dialectical behavioural therapy (DBT) groups.[3]

Throughout P2P’s work, the access needs for gender variant individuals in health care settings have been made clear.

Top three needs

All-gender bathrooms, inclusive in-take forms, and respect for an individual’s pronouns.

When these needs are not met, patients/clients report feeling like they are not respected or understood for who they are, which can result in them discontinuing treatment or not accessing health care in the future.

10 Tips for Engaging and Supporting LGBTQ Youth

  1. If you don’t know or understand a particular concept, “Google It” or ask a colleague.
  2. Avoid making assumptions about peoples’ gender, sex and sexual orientation.
  3. If you’re unsure about a person’s pronouns, ask them.
  4. If facilitating a group environment, incorporate a “pronoun go-around” and also ask if participants have any access needs.
  5. If you make a mistake, it’s okay. Apologize and make it right next time.
  6. Show that you support the LGBTQ community.
  7. Know your limitations in supporting someone and if necessary, refer to a colleague or another organization.
  8. Stay up to date and keep yourself informed about historical and contemporary LGBTQ issues. If you have learned something, share it with others.
  9. Ask the person what they want, what they need and how they want their experiences defined.
  10. Understand that not all queer and trans youth have the same experiences.

 

[1] 12-Step programs are community based supports where individuals who identify as addicts and alcoholics meet to mutually support one another.

[2] Located in the Parkdale area of Toronto

[3] The drop-in spaces include an abstinence night on Monday, a harm reduction space for racialized youth on Tuesdays and a harm reduction night on Thursdays. P2P regularly works with many addiction, harm reduction and mental health service providers in Toronto by providing LGBTQ and harm reduction advocacy, education and training. Once a month, P2P hosts a community harm reduction kit making event that is open to everyone, where participants can make safer use kits for crack use, injection drug use, crystal use and partying, as well as kits for injecting hormones and safer sex practices. P2P regularly attends drop-ins of partnering organizations and parties to do harm reduction outreach and to hand out kits.

 

My unconscious bias about young people, reproduction and “women’s health”

My unconscious bias was revealed to me many years ago while working as a registered nurse (RN) at a family planning clinic. A young woman came requesting a pregnancy test. I admit to feeling relief when the test was negative and was genuinely surprised when her reaction was grief. As we discussed the result, she revealed that she had been attempting to achieve pregnancy and had the full support of her partner and family. Where did my reaction come from? Why had I assumed that she was trying to avoid conception rather than trying to achieve it? Had my assumptions caused distress for the patient?

A rights-based approach to reproductive health means that everyone has the right to decide if, when and how often they have children. However, our unconscious bias – our inherent preferences that we’re not knowingly aware of – may impact the mental wellness of patients in our care.

As healthcare providers, we know that the mental wellness of our patients is impacted by many things, including gender, ability, relationships, socio-economic status, education, social support and access to services. But, do we consider the role of how our own comfort and bias impacts people during the significant life events associated with reproductive health care?

Even most of the research on reproductive health and mental wellness has focused on the experience of cisgender women in higher income countries. It’s a fact that the world of reproductive health is hyper-gendered and synonymous with women’s health. Have we unconsciously excluded transgender people, people with non-binary or gender non-conforming identities or men from research and supports that related to reproductive health and wellness? What is the experience of same-sex couples trying to access reproductive health care? Do we have enough information about the intersections of diversity and the impact on mental wellness?

Reproductive health across the lifespan is fraught with transition; consider the list: puberty, trying to prevent pregnancy, trying to get pregnant, infertility, pregnancy, parenting, adoption, abortion, miscarriage, and andropause/menopause. Is that it? I’m not sure, there is probably more. It’s a fact people can have increased risk to their mental wellness during these times of reproductive health transition. We need to be careful not to make assumptions about what the experience means for them, but also be aware of specific risks during these transitions, including:

  • Early puberty may be associated with impacts to self-esteem, body image and early sexualization.
  • Recent studies suggest that depression or feelings of decreased well-being may be possible side-effects of birth control pills. While research is still being conducted, counselling and support around the possibility is needed for patients.
  • Infertility is a stressful experience for all people, which impacts relationships, self-esteem, body-image and can be associated with experiences of anxiety, grief and depression.
  • People with a history of depression have a 20x higher risk of postpartum depression (PPD). Having gestational diabetes also increases the risk for PPD.
  • Risk factors for mental wellness during pregnancy and postpartum include smoking, use of alcohol, use of non-prescription drugs and a history of physical and/or sexual abuse.
  • Rates of mental health problems for women with an unintended pregnancy are the same whether they have had an abortion or have given birth; however, those with underlying mental health concerns may require additional supports.
  • Menopause may impact wellness for people who experience negative effects, including low mood, anxiety, body image, impact to self-esteem over loss of reproductive potential, reduced libido, difficulties with sexual functioning, etc.
  • Andropause may impact wellness for people who experience negative effects, including low mood, reduced libido, fatigue, body image/weight gain and difficulties with sexual function.

There are gaps. We don’t know, what we don’t know. But this is what I know to be true: as health care providers, we have an opportunity to work with vulnerable people during times of transition. For some people, this can be extremely stressful.

  • We need to avoid assumptions about the meaning of the experience and ask them, “How are you doing today?”
  • Avoid assumptions about how they might be impacted; what choices they might make or even whether they are aware of all their choices.
  • Be inclusive when talking about reproductive health and open the conversation to extend past “women’s health.”
  • Use inclusive language and avoid heteronormative assumptions using partner/spouse rather than husband/wife.
  • Know your resources, whether it’s for a person experiencing infertility and looking for assisted reproductive health technologies, a person looking for pregnancy options support, transgender youth during puberty or someone experiencing significant symptoms of perimenopause.

Ultimately, we all need the same thing. Access to timely, inclusive, non-judgmental, non-stigmatizing services. After all, reproductive rights are human rights, for all people.

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.

 

 

 

 

 

 

I have a 12 year old boy who has recently started to masturbate. We have a good relationship, but we haven’t yet talked about sex or sexuality. I want to make sure that he knows he can always talk to his parents about this and think it’s time to talk about safer sex with him. How can I talk to him about sex without embarrassing him or making him feel ashamed about his body and sex?

co-authored by Ashish Darji

Masturbation in adolescence is a natural exploration of one’s sexuality. It is common to see young adolescents start exploring masturbation around the age of 12 in Western society (and even earlier in other cultures). It seems that you are aware that your child must feel comfortable enough with his parents to talk to you about the sexually related experiences that he’s going through. An important part of parenting is to help guide your children as they grow so that they can make the decisions that are right for them. Open, clear, and honest communication between the child and parents is something that can help facilitate healthier decision making as the child gets older.

A child’s mind is very perceptive and receptive to minute emotions that parents elicit. Adults often don’t realize the influence they have over adolescents; they should use their power for positive youth development.[1] Feelings of shame and guilt can really stunt the sexual growth of adolescents.[2] A child’s home should be a space for open communication pertaining to the subject of sexuality. The most important thing that you can do is to meet your son at his level and view the world from his perspective. Be compassionate in that regard.

Open communication is central to healthy sexual development. No topic should be ‘off limits’ to talk about at home. As a parent, it’s important to communicate to your son by not simply making empty promises about open communication or saying things like “it’s okay to talk about anything” without following through. There is a vast and noticeable difference between saying you are allowed to talk about anything and actual honest and authentic communication, both verbal and non-verbal.

A child’s sexual development is proportional to that of his parents.[3] That is where he will learn the majority of decision making when it comes to sexuality. Your son may need you to approach him at his level of communication. Use what you know from your own experience and learning and be compassionate in answering his questions and supporting his sexual curiosity, to the point where his sexuality makes sense and fits in with his world view.

Discovering your sexuality as an adolescent can be a wonderful journey and open communication can help facilitate that. As a parent, you can help mitigate sexual risks through open communication about sexuality.[4] Open communication will do more than help your son navigate his own sexuality, it will also allow him to be more aware of the risks he may face in the future, such as unplanned pregnancies and contracting sexually transmitted infections. According to a study on parental monitoring and communication, constructive parental monitoring and effective parent-youth communication can play an important role in preventing risky behaviour during early to middle adolescence.[5] In the Netherlands, the societal and cultural narratives around adolescent sexuality are liberal and open minded. As a result, Dutch youth enjoy the benefit of having the fewest number of unplanned pregnancies and lowest rates of sexual infections.

Open communication about sexuality, social anxiety, intimacy, and sexual satisfaction are very closely linked.[6] When masturbation is considered by both the child and parents to be a healthy response to sexual development, it will benefit the child in many ways. Your son will have lower levels of social anxiety, greater intimacy and sexual satisfaction in the future if he is able to adopt and embody an honest and authentic dialogue about his sexuality.

Masturbation in adolescence is a complicated subject to navigate and must be approached with care as a parent. As a parent, you should first be aware of the intricacies that come with masturbation and how it affects the person both physically and psychologically. To allow your son to expand his sexual awareness properly, examine your parenting style so as to not impose any feelings of guilt or shame around sexual expression. Authentic and open communication between you and your child is the most important facet that will help your son navigate his way through any questions that he may have. It’s in your interest to inform him when he is seeking that knowledge.


[1] Clary, E. Gil, Rhodes, Jean E. (2006). Mobilizing Adults for Positive Youth Development: Strategies for Closing the Gap between Beliefs and Behaviors. The Search Institute.

[2] Aneja, J., Grover, S., Avasthi, A., Mahajan, S., Pokhrel, P., & Triveni, D. (2015). Can Masturbatory Guilt Lead to Severe Psychopathology: A Case Series.Indian Journal of Psychological Medicine, 37(1), 81–86. doi:10.4103/0253-7176.150848

[3] Wang, B., Stanton, B., Li, X., Cottrell, L., Deveaux, L., & Kaljee, L. (2013). The influence of parental monitoring and parent–adolescent communication on bahamian adolescent risk involvement: A three-year longitudinal examination. Social Science & Medicine, 97(Complete), 161-169. doi:10.1016/j.socscimed.2013.08.013

[4] Looze, M., Constantine, A. N., Jerman, P., Vermeulen-Smit, E., Bogt, T., Parent–Adolescent sexual communication and its association with adolescent sexual behaviors: A nationally representative analysis in the Netherlands – Routledge. doi:- 10.1080/00224499.2013.858307

[5] Wang, B., Stanton, B., Li, X., Cottrell, L., Deveaux, L., & Kaljee, L. (2013). The influence of parental monitoring and parent–adolescent communication on bahamian adolescent risk involvement: A three-year longitudinal examination. Social Science & Medicine, 97(Complete), 161-169. doi:10.1016/j.socscimed.2013.08.013

[6] Montesi, J., Conner, B., Gordon, E., Fauber, R., Kim, K., & Heimberg, R. (2013). On the relationship among social anxiety, intimacy, sexual communication, and sexual satisfaction in young couples. Archives of Sexual Behavior, 42(1), 81-91. doi:10.1007/s10508-012-9929-3

 

Back to School on Language: Making Sex Ed More Inclusive

It’s that time of year again and lots of high school students across Canada have headed back with big changes this year! Ontario has introduced a new sex ed curriculum that includes gender and sexuality from elementary school on; Quebec is piloting its new sex ed program; and the Vancouver school board is continuing to implement a very progressive trans inclusion policy. Championed together with huge victories for gay marriage in the US and giant media coverage of trans issues across Canada, this means that youth are bringing new questions to the table. With so many efforts going into making spaces as safe as possible for diverse groups of students and the people around them, teachers, parents, and school administrators are navigating new and murky waters trying to find ways to make it work. One such technique is adapting language to make it more inclusive.

I coordinate a program called SextEd, where people in Montreal can anonymously text questions that they have about sex, gender, and relationships and a team sends back researched, non-judgmental answers within 24 hours. While this is fantastic for answering questions that young people are too afraid to ask in person, 160 characters doesn’t tell us a lot about who is texting in. Early on, we knew that we would need to check our language to make sure that we weren’t making assumptions and accidentally hurting anyone coming to us for help. After working on this new challenge over a few months, we’ve found a few solid suggestions that work well, and we’re writing here to share them and potentially gain other tips from you in the comment section below! These tips were originally made with sex ed teachers in mind, but anyone who loves talking about sexual health can use them to adapt their own language!

Focus on Body Parts, not the Gender of People who Have Them

First off, as a general practice, we try to talk about body parts and what they do rather than assuming what body parts they have and what information they would need based on their gender. For example, trans women don’t need to get PAP smears, and many men don’t have Adam’s apples. Instead of making assumptions, we talk about body parts and say “people who have [insert body part here],” which takes gender out of the equation and makes what we say into simple truths: “people who have a cervix should get regular PAP tests,” “when penises ejaculate semen, they can release millions of sperm”—easy!

Look out for Gendered Safer Sex or Contraception Messages

Some men take the pill, and there’s a lot of unnecessary gendering when it comes to talking about safer sex. In some cases, this is really easy to fix! Saying “internal condoms” rather than “female condoms” is not only trans-inclusive, it makes it easier to talk about using them for anal sex! For other contraception, sticking to phrases like “people with ovaries” or “people who ejaculate semen” can let you explain what risks are relevant and how people can reduce them—all while staying gender neutral. Talking about safer sex in a gender neutral way can help you be more specific with your content, for example, “Giving analingus” tells your audience a lot more than “giving a woman oral sex.” This lets you talk about the specific risks involved and strategies to minimize them.

Open Up Limiting Statements

Another helpful tip is to avoid making limited statements. Adding words like ‘may,’ ‘might,’ or ‘could,’ can help include needs that are often overlooked. For example, “During puberty, people may start feeling sexually attracted to others” ensures that people who are asexual are not excluded. Saying that ‘many’ or ‘some’ people have experiences helps in the same way—“Many people have penises and vaginas that look like these diagrams” can acknowledge the experiences of people who are intersex without making them the focus. Having direct conversations around intersex anatomy can run the risk of peers reacting strongly and saying hurtful things, but small changes to language are a great way to normalize the incredible diversity of bodies and experiences!

Make a Difference with Inclusive Sex Ed Language!

Changing everyday language can seem daunting to a lot of people, but ultimately, it’s worth the rewards. Sex ed classes or conversations are already tense for most kids. While many can giggle that tension away, it can make a big impact when someone feels that that the information you’re giving doesn’t apply to them or makes something that discounts a big part of their life. Not being considered “normal” can lead anyone to disengage, no matter how relevant the information. When you make small changes in how you talk about sex, people will recognize the effort you’re making and will feel safer, more welcome, and more likely to ask questions that are important to them.

Learning More

If you’re interested in finding more ways to adapt your language, there’s a lot already out there that can help! Cory Silverberg’s fantastic sex ed books for younger kids make sure that a variety of experiences are included and encourage all kids to start learning what’s important to them. Scarleteen works to make its sex ed articles inclusive too! Planned Parenthood Toronto even has a whole website dedicated to sex ed for queer and trans people, giving key information that is usually left out of sex ed. The SextEd website also has a long list of answers to sex ed questions we’ve been asked and Action Canada will be launching a third edition of Beyond the Basics next fall, a great resource for educators on sexuality and sexual health with inclusive language and activities!

Still want more?

Check out our checklist for inclusive sex ed language and these helpful infographics below! (click on the images to enlarge)

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The Subtle Shift: Transforming Boys into WiseGuyz

The Calgary Sexual Health Centre (CSHC) specializes in helping young people learn about sensitive and emotional topics and more importantly, how these learnings can translate into behavioural change. Typically, education about sexual violence prevention and empowerment has been focused on women and girls, unintentionally ignoring the value of men and boys and their role in helping to create solutions. Research is now pointing to young boys as a key population for which to foster healthy, respectful and non-violent behaviours.

WiseGuyz

In 2010, the CSHC launched WiseGuyz, a school-based program created for junior high boys, who are at a critical point in their gender identity development. The program is voluntary and facilitated by male instructors, helping to create a relaxed and safe environment where the boys can examine their beliefs and assumptions about what it means to be a man in the world today.

WiseGuyz uses a progressive model, with significant attention placed on trust building. In the initial phase of the program, the focus is on creating a safe space and building rapport among participants. WiseGuyz curriculum is comprised of four step-by-step modules: 1) Human Rights; 2) Sexual Health; 3) Gender; and 4) Healthy Relationships

Masculinity and Sexuality are Intrinsically Bound

WiseGuyz encourages boys to be open, curious and not feel shame in asking questions about sex and sexual health. Ensuring boys are developing not only the knowledge about appropriate resources, but also the confidence to access them is critical to their sexual health and engagement in healthy relationships.

The research underscores the fact that masculinity and sexuality are intertwined and that sexual health programming must include education about masculine beliefs and stereotypes, and vice versa. The research explored topics like sexual relationships, safe sex, and sexual health care – and how each intersects with healthy masculinity concepts, such as confidence, self-expression and communication.

Research Findings: There was a 19% improvement in confidence in sexual relations for the participants of WiseGuyz. The increase in confidence indicates that the boys understand the importance of communication, boundary setting and discussing mutual expectations within sexual relationships.

Including sexual health within the curriculum provides students with the tools and resources required to inform and empower positive choices. By implementing this subtle, yet significant, shift in approach to educating young males about their sexual health and emotional literacy, WiseGuyz has earned a reputation for being a promising model for relationship change and a reduction in homophobia, bullying and violence.

wiseguyz-infographic11

Insight Theatre: Peer-to-peer, youth-led sex ed theatre troupe

For the past two-and-a-half years, I’ve been heading up a peer-to-peer, youth-led sex ed theatre troupe with Planned Parenthood Ottawa called Insight Theatre. Each year, we train a new group of high school youth in sexual and reproductive health, anti-oppression and performance skills. Once the youth are trained, they take the lead in creating a series of 15 or so skits on sex ed topics that they present to other youth at schools and community centres.

I’ve learned a lot in working with this project, but one of the most valuable lessons has been how youth access sexual health info and who they trust to get it right. In 2011, the Ontario Student Trustees Association reported that nearly half of all students were dissatisfied with the school-based sexual health education that they had received. The organization surveyed middle school and high school students across Ontario and found that 45% of respondents did not find their sex education classes to be useful or relevant to their own experiences. At the local level, the Ottawa Youth Sex Survey 2.0 found that 47% of participants did not feel comfortable seeking sexual health information from their teachers. But, this same group of respondents ranked schools as one of the top five locations in which they were likely to seek sexual health information.

Study after study has shown us that youth predominately get their information from peers and the internet. It is of course important to arm teachers, parents and other adults with accurate, evidence-based sexual health information, but we also need to equip youth with detailed sexual health info so that they can make the best use of this tendency toward peer-to-peer knowledge-sharing.

In my first year in this job, I started noticing how much casual, day-to-day peer education was happening between the Insight troupe members and their friends and classmates. In the bathroom at school and on a couch at a party, the troupe members were handing out free condoms, correcting misinformation and giving people info on where to go for STI testing, abortion care and affordable contraception. So we decided to formalize that part of the program. We gave the troupe members condoms to keep in their backpacks and created an information package so that they had the info they needed to refer their peers to local sexual and reproductive health (SRH) services as questions came up.

If youth are more comfortable talking to other youth about sex, then let’s train youth to talk to other youth about sex. There are lots of great sex education initiatives out there but, when it comes to really engaging youth, you have to pay attention to what they do and why. Youth trust word of mouth. They trust their friends. They trust the internet. Unless someone they trust has vouched for you, or you’ve proven upside down and sideways that you can be trusted, you’re not likely to get very far in terms of giving advice or being seen to have credible information.

Another big lesson I’ve learned in this job is that sex ed tends to go better when you indulge in a little infotainment. Over my last 15 years as an educator, I’ve noticed how much deeper arts-based educational initiatives go when it comes to youth and the ways they integrate information. Want to talk about anti-oppression? Analyze pop songs. Want to discuss consent? Show clips of TV shows. And, if you want them to listen when you talk about sex, present them with scenes that look and sound like their lives. Quote the TV shows they like, make reference to the songs they’re listening to and give them a chance to talk to their peers about what they’re thinking and feeling.