Barriers to Services and Health Care for Marginalized Students

Kathryn DeLucia-Burk,

Queer Consulting YQL

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Samantha Morneau,

Student VIP

Identifying and Overcoming Challenges to Accessible Services

Land Acknowledgement

We acknowledge that are meeting today in Mi’kma’ki, the ancestral and unceded territory of the Mi’kmaq People. We acknowledge the Indigenous, Métis, and Inuit individuals who have served as stewards of this land and who continue to do so. We are grateful for the traditional Knowledge Keepers and Elders, past and present, who fight to keep their cultures and traditions alive despite ongoing attempts of assimilation. We recognize the work of decolonization as ongoing and we as settlers have the responsibility to center Indigenous voices and challenge systemic oppression of Indigenous peoples. We acknowledge that a land acknowledgement is not the solution and we must take direct and meaningful action to challenge and deconstruct settler systems of oppression and amplify the voices of Indigenous peoples.

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Truth and Reconciliation Commission:

Calls to Action

Call to Action #21-

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We call upon the federal government to provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools, and to ensure that the funding of healing centres in Nunavut and the Northwest Territories is a priority.

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Introduction: Katie DeLucia-Burk (she/her)

• Self-identified queer, transgender woman
• 4th year undergraduate, Bachelor of Social Work
• Consultant & Educator, Queer Consulting YQL
• President, Board of Directors: OUTreach Southern Alberta Society
• Gender EDI Consultant, Office of Human Resources, University of Lethbridge
• Focus on:
• Trans feminist theory and research
• 2SLGBTQ+ Community Support & Health Resources
• Educational Programs for Communities and Service Providers
• Community-based organizing, activism & advocacy

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Introduction: Samantha Morneau

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Moving forward towards justice, engagement, and accessibility

1. Locating Barriers & issues
2. Consultation & Stakeholder Input
3. Student Empowerment
4. Resource Building
5. Finding Consistency
6. Harm Reduction
7. Engage in Active Allyship
8. Fostering Inclusive Spaces

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WHY do 2SLGBTQ+ folks experience barriers to healthcare?

1. Socially-constructed gender binary
2. Cis/Heteronormativity
3. Enforced dichotomy between gender identity and sex assigned at birth
4. Models of the “normal body” (cis, straight, white)
5. Stigma, internal bias, misinformation
6. Intersectional identities

(DC Department of Health, 2021)

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1. Locating & Addressing Barriers

Decolonizing Gender

(Potts, 2021).

(Geo Soctomah Neptune, 2020)

1. Locating & Addressing Barriers

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• Mental Health Supports: counseling, support groups
• Community & Social Groups: clubs & inclusive spaces
• “Coming Out” & Social Transition
• Vocal Training and Gender Gear: Vocal training is a means for trans folks to re-train their voices to sound more like their self-identified gender and ease dysphoria. Gender gear includes items trans folks utilize to both ease body-based dysphoria and ensure their safety. This includes:
• Trans-Masculine - binders, packers
• Trans-Feminine - gaffs and other tucking garments, wigs, breastforms
• Gender-Affirming Physicians: Able to provide informed general care & gender-affirming care
• Gender-Affirming Medical Care:
• Hormone Replacement Therapy
• Trans-Feminine: Anti-Androgen, Estrogen (injections, patches, or tablet)
• Trans-Masculine: Testosterone (injections or gel)
• Gender-Affirming Surgeries

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Key Components of Gender-Affirming Care

What are the barriers?

• Limited provider options, long waitlists
• Socio-economic & geographical barriers
• Discrimination (actual, percieved, or anticipated) & risk in disclosure
• ID’s & Healthcare cards
• Assessment criteria that deny intimate knowledge of self
• Pathologization of queerness & transness
• Performative allyship

(Trans Pulse Study, 2015)

1. Locating & Addressing Barriers

Locating and Addressing Barriers

How can we identify barriers?

• Consulting with Stakeholders (students)
• Engage in Critical Reflexivity
• What assumptions drive our decisions?
• What kinds of experiences would our own experiences and positionality render difficult to understand?
• “The Way Things Are Done” Audit - Using best practices to analyze existing policies, procedures, and approaches

1. Locating & Addressing Barriers

Navigating Gender Diversity in Administrative Spaces

• Vulnerability in Disclosure - Trans students are put at greater risk of violence and discrimination when procedures & policies that require them:
• Disclose their legal or “dead” name
• Be identified by their legal of “dead” name
• Disclose their gender identity for services, accomodation, etc
• Legal v. Chosen Names: consistent use of correct names and pronouns every time
• In correspondence, filing, forms, etc
• Only using legal name when necessary
• Respecting privacy & dignity
• (ex: asking for gender or sex in a form for which it is not needed for the function of the form)

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• Accomodation v. Inclusion

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1. Locating & Addressing Barriers

Information Collection

• Include space for pronouns and chosen name
• If “legal sex” is required, include a disclaimer stating why and how it will be used
• Multiple gender options with space to write in, (avoid male, female, & other)
• Know what you are asking: Avoid using “sex” and “gender” interchangeably

1. Locating & Addressing Barriers

Consultation & Stakeholder Input

Not sure how to best support and meet the needs of marginalized students? Ask them.

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• Our students are our best resource in identifying and addressing issues
• Consultation using focus groups, town halls, and surveys,
• Use input to identify what areas are presenting challenges and barriers to students.
• Include students in problem-solving.
• Compensation for emotional & physical labor

Pipeline for Student Input:

• Clearly marked and well-promoted contact form for student input, questions, and concerns.
• Ensure there is consistent management of this input and that messages are replied to, messages are conveyed to appropriate parties, and issues are addressed

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2. Consultation & Stakeholder Input

Student Empowerment

Student Organizing: Encourage and support student groups seek to represent and support marginalized groups

• Administrative support,
• Dedicated funding and spaces,
• Measures to ensure consistency in response to student burnout and turnover
• Staff support & Executive engagement
• Make space for student groups to be heard and utilize their expertise

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3. Student Empowerment

4. Resource Building

Resource Building

2SLGBTQ+ Resource Pages: Utilize local organizations, community-vetted resources, and input from students to populate and maintain a resource page that has:

• Information on relevant university policies
• Name change policies and links
• Campus organizations & safe(r) spaces
• Affirming healthcare and mental health resources
• Campus mental health supports
• Locations of gender-inclusive facilities (washrooms, changing rooms, etc)
• Crisis lines & emergency supports
• Education resources for allies, faculty, and staff
• Respectful use of pronouns, consistent use of chosen names, basics to navigating gender diversity

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4. Resource Building

Resource Building

Meeting student needs and fostering inclusive spaces

• Peer support and peer-led support groups
• Sober community-building and social events
• Ombudsperson and Human RIghts supports
• Resources in navigating university systems and offices
• Relationships with community and provincial organizations
• Seminars & workshops to educate student body on marginalized issues and experiences

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4. Resource Building

Finding Consistency

Preparing for Executive Turnover and Keeping New Execs in the Loop

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• Utilize policies, meeting minutes, project logs, and transition procedures to ensure that momentum on critical initiatives is not lost.
• Ensure student input and consultations are recorded and accessible
• Maintain records of ongoing objectives and goalposts for EDI-based initiatives
• Training for staff and new executives including equity, diversity, and inclusion approaches and perspectives from different marginalized groups.
• Framing training as an ongoing engagement with learning, not an item to be checked off a list

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5. Finding Consistency

Harm Reduction & Human Rights

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Implement best practices to reduce harm and respect human rights

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For 2SLGBTQ+ folks, this means:

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• Reducing / eliminating requirement for disclosure of gender identity or “legal” sex to access services
• Example: student health care plans & gender-affirming care access
• Identify when a policy, decision, or procedures reflect a normative model and excludes trans or queer students
• Awareness of percieved / anticipated discrimination as a barrier
• Use of inclusive language, chosen name, and correct pronouns

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6. Harm Reduction & Human Rights

The Power of Language

• Language can create barriers to spaces and services or just as easily as it can promote inclusivity and accessibility.

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• Implications of gendered language

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• Examples:

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• “he/she, his/hers” v. “they/them/theirs”
• “Sex” v. “gender”
• “You guys” “ladies and gentlemen” “ma’am or sir”
• Mr., Ms./Mrs., Mx.

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• Language is dynamic & culturally defined

6. Harm Reduction & Human Rights

Handling Misgendering with Grace

(Affinity Community Services, Sept. 2020)

6. Harm Reduction & Human Rights

Handling Misgendering with Grace

(Affinity Community Services, Sept. 2020)

6. Harm Reduction & Human Rights

Harm Reduction & Human Rights

• Respecting and honoring pronouns & chosen names. . .

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• Treating trans folks and their pronouns are a gift, not a burden. . .

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• Actively working to affirm all gender identities, expressions, and sexual orientations. . .

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• Challenging harmful narratives about queer and trans people. . .

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• Fostering inclusive, welcoming, and safe(r) spaces that mitigates gender dysphoria and promotes gender euphoria. . .

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...Saves Lives

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6. Harm Reduction & Human Rights

Acting Out As An Ally

Active Allyship for Meaningful Change

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Content Warning:

the following slides contain homophobic/transphobic language

7. Engage in Active Allyship

Covert Discrimination: Microaggressions

GLAAD-

trans microaggressions photo project #transwk

(Heffernan, 2015).

7. Engage in Active Allyship

Common Microaggressions

• Use of heterosexist or transphobic terminology.
• Endorsement of cisnormative or heteronormative culture and behaviors.
• Assumption of universal LGBTQ experience.
• Discomfort or disapproval of LGBTQ experience.
• Assumption of sexual pathology or abnormality.
• Denial of bodily privacy.

(Nadal & Jay, 2014)

7. Engage in Active Allyship

What is an ally?

(Hixson-Vulpe, 2017)

7. Engage in Active Allyship

What can we do?

T - Take the time to listen and learn when our own experiences and knowledge are limited.

E - Educate your friends, family, peers, students, and educators.

A - Acknowledge the unpaid labor expected of queer and trans folks to advocate for their own safety, inclusion, and dignity.

C - C - Calling in to learn, rather than calling out by avoiding defensive reactions when our assumptions are challenged

H - Hear something? Say something. Don’t tolerate hate.

7. Engage in Active Allyship

Inclusive Spaces: Visible Cues

Pride Flags

Pride Buttons

Pride or Safe Space Stickers

Diversity Posters

Public statements of inclusion & acceptance

Performative Allyship

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(True Colors United, 2021)

8. Fostering Inclusive Services

• Normalizing asking for pronouns- using them in emails sign-offs, Zoom display names, etc.
• Consistent use of chosen names
• Inclusive forms & language in administrative spaces.
• Avoiding heteronormative, cisnormative, and eurocentric language/assumptions.
• Making space for respectful discussions on gender and sexuality while respecting privacy
• Mandatory training on basics of gender identity & sexuality
• Strong policies and procedures that ensure inclusion, safety, and dignity for all

Inclusive Spaces: Visible Actions

8. Fostering Inclusive Services