Creating Safer Spaces for 2SLGTBQ+ Emerging Adults in Health-care (Forum Report)

MHCC/W2A: Rainbow Youth Health took place at the Wabano Centre for Aboriginal Health in Ottawa, November 8-9, 2018.

Two-Spirit, lesbian, gay, bisexual, trans, and queer (2SLGBTQ+) emerging adults face particular challenges that put their mental health at greater risk, including significant barriers to health-care access. To support the larger goal of increasing health-sector access and improving the service-user experience for 2SLGBTQ+ emerging adults, the MHCC and W2A hosted a pan-Canadian forum aimed at creating safer spaces in health-care settings. Created and hosted in partnership with 2SLGBTQ+ emerging adults between 18 and 30, the forum provided a platform for young people to amplify their voices.

Across Canada, 2SLGBTQ+ individuals, allies, communities, organizations, and health-care professionals are addressing these issues through programs, services, and research. Young people play an important role in identifying the problems and solutions. Youth know the pathways to their own wellness and life enhancement. They lead programs in their communities that support other young people. They provide important peer support, both formal and informal. They are advocates for themselves and their communities.

Participants at the forum travelled to Ottawa from across Canada to share initiatives and approaches to increasing health-sector access and improving the service-user experience for 2SLGBTQ+ emerging adults. The discussions focused on youth-led initiatives and perspectives to make an emerging adult’s experience safer and more inclusive. The forum provided participants with an opportunity to share best and promising practices for improving services to those affected by gaps and barriers in accessing health care.

Emerging Themes

Many themes emerged from the rich discussions throughout the day. There was no shortage of ideas when it came to creating safer spaces in healthcare settings for 2SLGBTQ+ emerging adults. There were many commonalities that bridged all of the presentations and conversations. But which recommendations should serve as starting points for action? And what will fulfilling those recommendations actually look like?

Below is a list of guiding principles that attendees emphasized should factor into any initiative moving forward. Future work related to 2SLGBTQ+ safer spaces in healthcare should aim for the following:

• Be trauma-informed to build client safety and trust
• Meet clients “where they’re at” using a harm-reduction lens
• Create safety for Indigenous and racialized 2SLGBTQ+ clients and providers with anti-racist and antioppressive frameworks
• De-colonize healthcare through an equity-based approach rooted in the social determinants of health and a focus on holistic health and wellness
• Assure respect for confidentiality
• Uphold informed consent

Areas for Future Action

The following themes emerged across participant perspectives, helping to inform four overall recommendations for long-term action:

• Raise awareness on the importance of safer spaces in healthcare settings for 2SLGBTQ+ emerging adults. This should involve sharing firsthand accounts of people with lived experience, including their experiences of gaps and barriers in the healthcare system. Connecting with allies in healthcare is an important step to advancing change in the healthcare system, though ally voices should never speak over or on behalf of 2SLGBTQ+ communities.
• Prioritize intersectionality by ensuring your strategies are rooted in anti-oppressive and anti-racist frameworks that meet the unique needs of all 2SLGBTQ+ communities, including members who are Indigenous, racialized, or who live in rural or remote areas.
• Build momentum across the healthcare and 2SLGBTQ+ serving sectors. There is great work happening and we need to learn from promising practices across the country. Peer support and youth-led initiatives are of particular interest and importance. Most importantly remember that 2SLGBTQ+ young people know their experiences and stories best. Ask for their input, listen to their ideas and recommendations, and let them lead.
• Affect change through actionable strategies. Invite service providers, policy makers, and other decision makers to be part of the change. Concrete ideas include the development and implementation of rigorous, mandatory, and ongoing training rooted in best practices. Positive change also requires research and evaluation through the collection, monitoring, and reporting of data. Check-list tools are another great way for organizations to evaluate the presence or absence of required knowledge, skills, or behaviours.