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Providing Diversity Competent Care to Two- Spirit Clients

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Providing Diversity Competent Care to Two- Spirit Clients PROVIDING DIVERSITY COMPETENT CARE TO TWO- SPIRIT CLIENTS A HANDBOOK FOR HEALTH CARE PROVIDERS This handbook will provide you with information on the best practices in providing care to Two-Spirit clients/patients/residents. PROVIDING DIVERSITY COMPETENT CARE TO TWO-SPIRIT CLIENTS Fraser Health Authority 2015 This document is licensed under a Creative Commons Attribution, Non-Commercial, Share Alike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc- sa/4.0/deed.en_CA. You are free to copy, communicate and adapt the work for non-commercial purposes, as long as you attribute Fraser Health Authority and distribute the resulting work only under the same or similar license. For permissions beyond the scope of this license, contact: Fraser Health Diversity Services Fraser Health Authority 400-13450 102nd Avenue Surrey, BC V3T 0H1 E-mail: [email protected] Phone: +1 604-587-4486 For further information, contact: Fraser Health Diversity Services Fraser Health Authority 400-13450 102nd Avenue Surrey, BC V3T 0H1 E-mail: [email protected] Phone: +1 604-587-4486 Suggested citation: Fraser Health Authority. Providing Diversity Competent Care to Two-Spirit Clients: A handbook for health care providers. Diversity Services, Fraser Health Authority. British Columbia 2015. 2 For more information contact [email protected] PROVIDING DIVERSITY COMPETENT CARE TO TWO-SPIRIT CLIENTS TABLE OF CONTENTS An Important Note on Diversity Competent Care ......................................................................................................... 9 A Brief LGBTQ2S History .............................................................................................................................................. 10 Demographics .............................................................................................................................................................. 13 Barriers to Health and Health Care FOR LGTBQ2S PATIENTS/CLIENTS/RESIDENTS .................................................... 14 Societal-level Barriers ......................................................................................................................................... 14 Health Care Environment/System Barriers ......................................................................................................... 18 Waiting Rooms / Exam Rooms ................................................................................................................... 18 Intake Forms .............................................................................................................................................. 18 Lack of Education and Training on LGBTQ2S Health and Health Care ....................................................... 18 Lack of Institutional Support ...................................................................................................................... 19 Health Care Provider Barriers ............................................................................................................................. 20 Referrals ..................................................................................................................................................... 20 Discomfort .................................................................................................................................................. 20 Language / Communication ....................................................................................................................... 21 Negative Stereotypes / Attitudes ............................................................................................................... 21 Discrimination ............................................................................................................................................ 21 Highlighting Complexity in LGBTQ2S Health ....................................................................................................... 22 According to Canadian data from the National Population Health Survey… ............................................. 22 According to the recent Provincial Health Officer’s Report entitled HIV, Stigma and Society… ................ 22 According to THE combined data from the 2003 and 2005 Canadian Community Health Survey... ......... 23 According to the Trans PULSE study completed in Ontario, Canada… ...................................................... 23 According to the National Transgender Discrimination Survey in the United States….............................. 24 According to the very few studies of Two-Spirit people in North America................................................ 24 Best Practices for Providing Diversity Competent Care Guidelines .................................................................... 26 Institutional and Organizational Best Practices ......................................................................................... 26 3 For more information contact [email protected] PROVIDING DIVERSITY COMPETENT CARE TO TWO-SPIRIT CLIENTS Visual Inclusion ........................................................................................................................................................ 26 Informational Inclusion ........................................................................................................................................... 28 Policies, Forms, and Patient Literature ................................................................................................................... 29 Training and Knowledge Sharing ............................................................................................................................. 31 Gender Inclusive Washrooms ................................................................................................................................. 32 Organizational Culture and Consistency ................................................................................................................. 33 Outreach.................................................................................................................................................................. 33 Process for Complaints ............................................................................................................................................ 33 Health Care Provider Best Practices ........................................................................................................... 34 LGBTQ2S ............................................................................................................................................................. 35 Knowledge .................................................................................................................................................. 35 Distinguishing between sexual attraction, sexual identity, and sexual behaviour ................................................. 35 Distinguishing between sex, sexuality and gender ................................................................................................. 37 Distinguishing between sexual attraction and gender expression.......................................................................... 39 Distinguishing between gender identity and gender expression ............................................................................ 40 Understanding the diversity of lesbian, gay, bisexual, trans, queer and Two-Spirit people ................................... 40 Multiple identifications are possible ..................................................................................................... 41 IDENTIFICATIONS BEYOND LGBTQ2S ARE POSSIBLE .............................................................................. 41 Similarities and differences in experiences ........................................................................................... 41 Queer ..................................................................................................................................................... 42 Diversity ................................................................................................................................................. 42 Coming Out ............................................................................................................................................ 43 Families .................................................................................................................................................. 44 Reflecting on Attitudes ............................................................................................................................................ 45 Exercise 1 – Reflecting on Assumptions (adapted from 23, pg 8.) ................................................................. 46 Exercise 2 – Reflections on Word Associations (adapted from 23, pg. 8) ...................................................... 47 Exercise 3 – Reflecting on Privileges ............................................................................................................... 49 4 For more information contact [email protected] PROVIDING DIVERSITY COMPETENT CARE TO TWO-SPIRIT CLIENTS Instructions ...........................................................................................................................................
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