April 5, 2007
Introduction
In Ottawa, there is no document describing the needs of trans people other than a Trans Legislative Needs Assessment document prepared by Chris Boodram and Corie Langdon in 2004. This document does not articulate the wellness needs of trans people.
In 2000 a Community Wellness Survey was co-sponsored by Pink Triangle Services and the City of Ottawa to inquire into the state of LGBT people in Ottawa. The results were over-represented of gay men and under-represented of all other members of the community–especially trans people.
In recent months there has been a convergence of thinking and action in the Ottawa Trans Community.
It is in the light of this development that on November 21, 2006–as part of Trans Day of Remembrance events–a meeting of trans people was held to generate a needs document for trans people in Ottawa.
It was held on the premises of Pink Triangle Services, which supported this initiative, as did Gender Mosaic, Trans Youth Ottawa, the Gay Lesbian Bisexual Trans Two Spirit and Queer Community Centre of Ottawa and the Ottawa Police Service LGBT Liaison Committee.
Participants responded to invitations on email lists and word of mouth.
At the meeting it was decided that participants would be offered the opportunity to contribute to the drafting of the final document. It was circulated by email to participants on February 19, 2007
Trans People
“Trans” is an umbrella term for transgender and transsexual people.
These, and all other terms describing those who in their lives challenge the gender stereotypes of society–as all trans people do–are fluid; not all people who use these terms–or even all those who might be identified/described by these terms–accept them.
They are evolving.
Only a minimum of terminology has been used in this document.
Self-identification is considered paramount; people are accepted as they describe/present themselves. This also conforms to the Safe Space Policy of Pink Triangle Services where the consultation took place.
Transgender generally includes those who dress in the clothes and present in the gender they were not assigned at birth for lesser or greater periods of time but who retain their birth-assigned gender.
Transsexual people are those who who, out of great dysphoria with their birth-assigned
gender, seek through hormone replacement therapy, gender transition and surgery to the fill the gender role in society they were not assigned at birth.
There are also those whose gender presentation is neither masculine nor feminine according to society’s expectation and those who present as both masculine and feminine in alternation.
Those who participated in the Consultation were primarily transsexual people–both Male to Female and Female to Male.
Because of the challenge to society’s expectations of gender and gender presentation trans people of all descriptions are marginal in society and all the communities in which we seek to be members. Trans people face challenges in accommodation, services and employment.
Arguably trans people are the last in society whose human rights have yet to be formally recognized; this contributes to our universal marginalization and its many consequences in wellbeing—physical and mental—that naturally and inevitably arise from marginalization..
Rarely are trans people ourselves asked what our needs are–others routinely usurp this role.
The Ottawa Trans Community Consultation was undertaken in order to break the silence regarding our needs.
This document is the result.
Recreation
In the area of Recreation one of the greatest single barriers to participation of trans people is
the availability of changing facilities. In some situations Male to Female trans people are required to use Men’s Changing Facilities and Female to Male people are required to use Women’s Changing Facilities.
At the very least this can be embarrassing.
It can also be very dangerous and/or lead to legal complications.
The use of Family Changing Facilities–with the privacy provided–can help, but places like the YMCA may not be willing for trans people to use them because they are not ‘families.’.
In Ontario, the Ontario Human Rights Commission mandates that those trans people who are full time use the gender segregated facilities that conform to their full time presentation. However, the exercise of this right, as the exercise of the rights of all marginal people, can sometimes be so complicated that it discourages all but the most determined.
This is further complicated by the lack of statutory and well-known rights–such as those for gay and lesbian people.
The determination necessary to claim rights may not always be available to those who are marginalized.
Public Rest Rooms
Possibly the single most inflammatory situation for all trans people is the use of public rest rooms. Especially for early transitioners–and for those who do not easily pass–this can, as the use of Change Rooms, be at least embarrassing and often dangerous. And unlike the use of Changing Rooms the use of rest rooms is not optional–without great discomfort and medical consequences.
To be challenged on the use of a public rest room–and the use of one is always when in need–is an affront to the fundamental dignity we hold to be due all Canadians.
It has often been suggested that certain institutions–such as universities/colleges, shopping malls–provide more single stall washrooms. Also, that these institutions be made aware, and make their clientele aware, that in Ontario full time trans people have the right to use the gender segregated facility that conforms to their gender presentation.
Public Education Campaigns also with respect to the actual danger trans people present to cisgendered (non-trans people) in public facilities–none at all–should also be considered.
Trans people, marginal in all these situations, are the ones at risk.
Women’s Shelters
Although many women’s shelters have adopted policies permitting trans women to use their facilities, the recent refusal of the Supreme Court of Canada to hear the appeal of Kimberly Nixon regarding her exclusion from the Vancouver Rape Relief Society’s shelter training program continues to place in jeopardy the acceptance of trans women from the facilities dedicated to sheltering women from assault.
This would have been the first case concerning the rights of trans people heard by the Supreme Court of Canada. This refusal is a blow felt by all trans people.
Sports
The role of athletes as role models, particularly for trans youth, was identified, as was the need for networking with those trans athletes who are out.
Youth
Trans people are marginal and trans youth even more marginal within society.
As with any marginal youth the need for employment services was voiced, including employment data banks of trans-friendly and trans-unfriendly employers, information for employers on trans people in general and trans youth in particular.
Scholarships in the community for trans youth were proposed, possibly sponsored by Pink Triangle Services and/or other organizations in the community.
Above all, the concern of reaching out and contacting trans youth, much along the lines Trans Youth Ottawa has pioneered was expressed.
Health
While there is some information on the health concerns of trans people out there it is not readily available–and in some cases it is not available at all; there is some information about transsexual people but little about transgender people.
This is a list of specific health information participants provided:
1) HIV/AIDS
2) STD’s
3) Reproductive Options
4) Post Transition health concerns
5) Breast/prostate health
6) Health Risks of Transition
7) Long Term Effects of cross-hormone replacement
Female to Male Concerns:
Cholesterol
Stress Responses
Polycythemiavera
Muscle growth without tendons growing
Anger management
There was the unanimous expression of the need to sensitize medical professionals and other providers of services to the specific need of trans people and of what constitutes treatment with compassion and dignity.
The Ottawa trans community is deeply concerned by the lack of doctors knowledgeable in trans health issues and willing to prescribe hormones in the Ottawa area and by the fact that the Ontario Government currently does not list surgery or any other transition service as a necessary medical service under medicare.
The frequent dismissal of the necessity of these services as cosmetic and trivial is one indication of the marginalization of transsexual people—and materially contributes to depression, alienation, other mental concerns and physical sonsequences of dysphoria.
The community expressed its desire to give the medical community feedback on its concerns.
Only those transsexual people with either their own independent resources or those whose employers have generous insurance can now access surgery.
Surgery for transsexual people is no different than surgery for others to treat physical disorders. Necessary medical treatment should not be be matter of money.
Mental Health
Excluded from the mainstream of society by our nature, trans people face serious depression and other problems of mental health. The alienation that is commonplace leads to the highest suicide rates–though not documented because of our marginalization; it is this very marginalization and exclusion that is the breeding ground for suicide.
It is noted that while the suicide rates of gay and lesbian youth is far higher than for straight youth it is nevertheless clear there are supports in place for them: adult gay role models, explicit human rights and the profile that goes with it, gay-straight alliances in high schools, PFLAG chapters.
It is true gay-straight alliances and PFLAG–Parents, Families and Friends of Lesbians and Gays–chapters welcome trans youth, the fact that they do not includes trans people in their names is part of the absence of recognition of trans youth
Although every trans person knows the effects of not treating gender dysphoria it is not clear how much if any of this information is available to those organizations and individuals who have the authority to address it.
Employer Health Insurance
Given that medicare, at least in Ontario, has long given up any semblance of serving the needs of trans people concern was expressed about the possibility of employer’s health insurance covering the needed services.
The only catch is that one must must be employed in more than a part time or casual position in a company that does have health insurance.
Recommendations
In addition to the needs detailed above, the community makes a number of specific recommendations it believes can be accomplished in Ottawa to begin to address its needs:
1) Workshops to help those beginning their transition to develop the confidence and self-esteem necessary to live in the world. They would include the following topics:
Washroom issues as discussed above, including the right of those full time presenting to use the gender segregated facilities that conform to their presentation.
Women’s shelters, also as discussed above.
Transitioning rights, including those discussed above and the obligations of employers, in particular, as mandated by the Ontario Human Rights Commission.
A bathroom map, as has been created in other jurisdictions, showing where single stall washrooms are available and/or institutions where the issues of trans people using public washrooms have been settled.
2) A Community Health Centre to, in one location, bring together the necessary health care providers to address all the medical, psychological and social needs of trans people in Ottawa.
3) A Legal Clinic where specifically legal concerns, including, but not limited to marriage, divorce, adoption and legal name changes, including changing names on diplomas and degrees, can be addressed and supported by qualified legal counsel.
4) A Community Support/Advocacy Worker, to be housed in a community organization such as Pink Triangle Services, to support trans people in their struggles with accommodation, services (including health services), employment, advocating for them in these situations and working to bring about the goals/addressing the needs articulated in this document.
Acknowledgements
The support of Pink Triangle Services and its Interim Executive Director, Wayne Adams, and its Office Administrator, Claudia Van den Heuvel, is acknowledged.
The Ottawa Trans Community Consultation was organized and facilitated by Jessica Freedman. This document was prepared by Jessica Freedman.
References
The Ottawa-Carleton GLBT Wellness Project
http://www.pinktriangle.org/wellness/main.html
Trans Legislative Needs Assessment
http://www.egale.ca/index.asp?lang=E&menu=34&item=998
Further information about trans issues can be found here:
http://www.egale.ca/index.asp?lang=E&menu=34
Some information on trans, queer and two spirit youth can be found here:
Bent and Unbroken, Egale Canada, 2005. A report of a Symposium held in Toronto in October, 2004.
Ontario Human Rights Commission:
Policy on Discrimination and Harassment because of Gender Identity (approved by the Commission March 30, 2000)
http://www.ohrc.on.ca/en/resources/Policies/PolicyGenderIdent?page=PolicyGenderIdent-Contents.html
Toward a Commission Policy on Gender Identity: Discussion Paper (dated October 1999)
http://www.ohrc.on.ca/en/resources/discussion_consultation/DissGenIdentFtnts?page=DissGenIdentFtnts-Contents.html