What is social exclusion?

On the Public Health Agency of Canada’s website, there is a section on social determinants of health. In particular, there is a sub-section on social exclusion.

All of the documents on this site are not necessarily the opinion of the Agency, though I suspect that placing these documents on the site, originally presented at a conference in 2002, implies some support.

2002 is an interesting year.

It was the the year Sven Robinson refused to include gender identity and gender expression in his private member’s bill which, with rare all-party agreement in the Parliament of Canada, amended the Criminal Code of Canada hate sections to include sexual orientation. After his bill passed, Robinson vowed to work for the inclusion of gender identity and gender expression.

Gender identity and gender expression remain outside both the Criminal Code and the Canadian Human Rights Act–and all provincial human rights laws–to this day.

This may explain the inclusion of sexual orientation in these documents on the Agency’s website but not gender identity and gender expression.

There are four aspects of social exclusion

  • Exclusion from social society
  • Exclusion from social goods
  • Exclusions from social production
  • Economic exclusion

Any one of which significantly degrades wellbeing–I argue, not controversially, I hope, that this not only describes the status of gay and lesbian people, but, because of the formal legal exclusion of transgender and transsexual people from human rights and hate crimes legislation, social exclusion presses with particular and unique emphasis on transsexual and transgender people.

In the struggle I was part of while working at Canadians for Equal Marriage, we spoke about bringing gay and lesbian people from the margins to the mainstream of society by legally recognizing their relationships–we even spoke about this being the natural extension of their human rights.

The healing of gay and lesbian people from the trauma of homophobia, and its consequent exclusion from society, began with the formal and explicit recognition of this exclusion–and this recognition was not limited to gay and lesbian people and their organizations, but was quite wide-spread throughout society, including health and social service organizations and professional organizations of service providers.

This explicit recognition, including express statements pointing at the void in human rights and hate crimes legislation, was part of the healing from this trauma. The explicit declaration that gay and lesbian people are part of society.

Nor is it, I hope, controversial to say this explicit recognition, including express statements, was the indispensable step, necessary even before legislation and certainly before moving “beyond law reform” as Laurie Arron declared after Prime Minister Harper gave up the campaign to repeal the same-sex marriage law

As we move beyond law reform, we face the challenge of changing hearts and minds, and of making everywhere across Canada safe and welcoming for LGBT youth, LGBT seniors, LGBT families and their children.

My critique of this position is quite simple–why now, after the legal achievements regarding sexual orientation have been made, but before those concerning gender identity and gender expression have hardly been begun, is it appropriate to abandon transgender and transsexual people in the legal and social void that gay and lesbian people have, since 2002, left for the mainstream?

Why is silence on the very same legal and social void appropriate when it concerns transgender and transsexual people?

Why are not all our allies–of equality and human rights–past, present and future, explicitly and expressly speaking out and pointing at this void?

Rainbow Health Ontario (RHO) is one of the sponsors of Egale Canada’s April 1 event on homophobic and transphobic violence in Canadian Schools. I have previously had the opportunity of commenting on Rainbow Health Ontario.

This was in connection with their declining my application for the position of Community Engagement Team member for the Champlain Local Health Integration Network–which includes Ottawa and Cornwall. They decided to go with a gay man who has a long and impressive history working with gay men and their health needs. Capital Xtra about a year ago lauded his successful political efforts to put gay men back into the campaign against HIV/AIDS.

I had the opportunity to meet him once during the years I have been active in the struggle for trans rights and services. And once he came into the book store where I work.

My concern with RHO was with its statement in its notice for the Community Engagement Team members, repeated on its website–created since then–under Why is this Resource Needed?

Despite significant improvements in human rights of LGBT people in Canada, there are still gaps and inequities in services and in the health status of LGBT people.

In my Open Letter to RHO, I laid out the history of gaps and inequities in human rights status. The legal and social void where gender identity and gender expression should be.

There is nothing transsexual and transgender people can point to regarding our inclusion in society in what many consider the foundation of that inclusion.

This is quite similar to the statement Ottawa Pride made in 2005–in the euphoria just two months after the passage of the Civil Marriage Law, i.e. the same-sex marriage law:

All LGBT people in Canada have human rights and its time to celebrate.

I discuss my concerns with this repudiation here.

This becomes all the more concerning when placed beside RHO’s commitments, its beliefs and principles, which include social determinants of health

We believe that the social, cultural, political and economic context of peoples’ lives has a big impact on their health.

In many of the discussions I have been privy to, both online and in various agencies’ meetings, the question of the mental wellbeing of gay men has come up, particularly in the context of the homophobia experienced, the alienation from the mainstream and the impact this has on the physical and mental health and risk taking that often follows–and consequences with respect to HIV/AIDS.

This was certainly the reason Capital Xtra celebrated the achievement of the man who was accepted by RHO for its Community Engagement Team for the Champlain LHIN–the explicit recognition of gay men as being disproportionately affected by HIV/AIDS.

There can be no doubting this.

(We simply have no quantitative information regarding the effect of HIV/AIDS on transgender and transsexual people.)

The Supreme Court of Canada supported this also, when it recognized sexual orientation as an analogous right to those enumerated in Chapter 15 of the Charter of Rights and Freedoms:

Deliberate exclusion of sexual orientation resulting in serioux discriminatory effects, including denial of access to remedial procedures and psychological harm from implicit message that homosexuals are not worthy of protection. (p. 25)

The Court has not yet been asked this question with respect to transgender and transsexual people–but can anyone doubt their answer?

Can anyone doubt the “psychological harm resulting from [the] implicit message” that transgender and transsexual people “are not worthy of protection” also?

Also in the repudiation by Ottawa Pride and RHO?

The Canadian Human Rights Act Review Panel was asked; this is their answer:

Although the Panel recognized that the Act currently protects these individuals from discrimination on the ground of sex or the combined grounds of sex and disability, it felt that the law fails to acknowledge the particular situation of transgendered persons and thereby render them invisible. In view of the substantial harm that can be suffered by these persons, the Panel recommended that the Act expressly provide them with legal protection.


Why do I even have to raise this concern, not only once, but for the second time?

Yes, RHO is collaborating with the Trans PULSE Project, but I wonder why it is silent on the human rights status of transsexual and transgender people and the impact this has on our health.

Is this not considered a significant contributing factor to wellbeing with disproportionate effect on transsexual and transgender people?

Is an imposted unity perspective, like that I identified in Egale Canada and its supporters, the ideology that only LGBT issues can be addressed and declared–not those of a subset of LGBT–at work in RHO?

Does this ideology mean that even a commitment to social determinants of health, particularly the apparent recognition that social exclusion “has a big impact on [our] health,” will be compromised to maintain unity?

Why does RHO refuse to acknowledge probably the most significant social determinant of health for transgender and transsexual people–our formal exclusion from human rights and hate crimes legislation?

This repudiation and erasure throws us into the social and legal void.

What is social exclusion?

This refusal of Rainbow Health Ontario to explicitly recognize that transsexual and transgender people are excluded from human rights and hate crimes legislation is social exclusion.

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