3 min

The future of queer health care

Opening up the system to queers

Credit: Capital Xtra files

“What’s happening with [queer] health throughout the country is incredibly exciting,” Dawn Archambault explained at the recent conference of the Canadian Rainbow Health Coalition (CRHC) in Gatineau.

Formed in 2001, the coalition is a national organization that addresses health and wellness issues directly related to homophobia and heterosexism. After receiving funds from Health Canada, the CRHC signed partnership agreements with eight organizations that are working to improve the health and wellness of LGBT people in Quebec City, Abitibi-Témiscamingue, Quebec, Toronto, Saskatoon, Vancouver, Victoria and Halifax.

Although these organizations are all concerned with health care and its service delivery, the project that will bring about a fundamental systemic change is the Halifax Rainbow Health Project. Its main goal is to increase access to primary health care for the rainbow community within the Halifax regional municipality. Once complete, it will become a template of best practices that can readily be adapted to other communities throughout Canada. Dawn Archambault is the Halifax Rainbow Health Project Coordinator.

“The message I hear over and over again is that people are encountering homophobic doctors,” says Archambault.

Her statement is confirmed by a statistic from the CRHC. In Ontario, 87 percent of LGBT people have reported experiencing discrimination within the health care system.

“After that experience,” says Archambault, “not only do people not have a doctor, but they may also not be practicing preventative care. Their health issues may go unaddressed, and can possibly snowball into something serious.”

Many lesbians who make a few unsuccessful attempts at seeking a health care provider stop seeking care altogether. Within the overwhelmingly homophobic health care system, this is unfortunately the rule, rather than the exception.

“Even if they have a doctor,” says Archambault, “many lesbians are often unable to discuss specific health care issues that pertain to them, whether that is coming out or talking about their sexual practices. They’re instead given advice related to women who identify as heterosexual.”

This begs the question: what are the health concerns of lesbians?

Diagnostically, some studies show that lesbians may be at risk of breast cancer due to a combination of high Body Mass Index levels, alcohol consumption and not having children or having children later in life. Other studies have indicated that rates of cervical cancer are equal between lesbians and heterosexual women. Nevertheless, it continues to be difficult for lesbians to get pap smears. They are often considered a low risk group by the medical establishment – the assumption being that cervical cancer is linked to heterosexual intercourse.

To identify its priority actions, the CRHC has set out health determinants that pertain specifically to the queer community. Historically and statistically, research has shown that we are lacking in the areas of social support networks, income status, childhood upbringing and education levels. These are all areas that affect our health. As a result, queer people commit suicide at least three times more than the general population, smoke at twice the rate and experience substance abuse problems at least three times more often. When compared to the mortality rates of straight people, research shows that queer people die before they otherwise would have as a direct result of society’s systemic homophobia.

“Under-employment, work stress and discrimination or perceived discrimination by an employer are other determinants of health,” Archambault explains. “These health-related issues may also include the lack of someone’s ability to be themselves or to come out. Coming out continuously also affects people’s health.”

The result of focus groups run by the Halifax Rainbow Health Project is that queer Haligonians want a specific health centre for their community. The Halifax Rainbow Health Project is also mandated to make education on health issues related to LGBT people compulsory for health providers. Rather than instituting a separate workshop or course in medical schools, the goal is to normalize the queer community. This would mean ensuring that case studies used in curricula cite LGBT people across the board and at every level of the system. Equally important would be the inclusion of training on LGBT health issues as a continuing education requirement for primary health care providers.

“Making health care accessible means looking at policies, services and how doctors approach their clients. This includes having diverse pictures on the walls of their offices, and not making assumptions about people,” explains Archambault. “Momentum is rolling across Canada. Within the next five years, there will be huge changes in terms of the rainbow community’s access to the health care system.”