The College of Pharmacists of BC Supports the 2SLGBTQ+ Community
As part of Pride 2020, The College would like to remind all healthcare providers of our shared duty to ensure safe and effective care for 2SLGBTQ+ patients.
While Pride Season - typically reserved for large community celebrations and awareness events – is going to look a little different this year, the vibrancy and strength of 2SLGBTQ+ communities across BC continues to shine.
As health professionals, we need to continue to reflect on how we are creating a welcoming and safe environment for 2SLGBTQ+ patients in the care we provide. Today, coming out about your sexual or gender identity is still a difficult experience for many Canadians. Homophobia, transphobia and discrimination are still pervasive within our culture and continue to impact the lives of 2SLGTBQ+ communities.
This stigma and discrimination affects all facets of life for 2SLGBTQ+ individuals, including access to health care. People who identify as 2SLGBTQ+ in Canada continue to experience numerous health inequities, often resulting in an inability to have their healthcare needs met.
There are many barriers that 2SLGBTQ+ people face when accessing healthcare services. In a national study on healthcare for trans people in Canada, it was reported that 45% of trans and non-binary respondents said they’d experienced having one or more unmet healthcare needs within the past year, while 12% had avoided going to an emergency room, despite needing urgent care.
Similarly, a June 2019 report by the Standing Committee on Health found that up to 60% of 2SLGBTQ+ people do not talk to their health care providers about their sexual orientation, while those that do often need to educate health professionals about their risk factors or health needs. Moreover, the report cited incidents of health care workers refusing to treat people belonging to sexual or gender minorities because they do not feel that they are sufficiently trained – which can lengthen the time it takes for 2SLGBTQ+ people to access care.
2SLGBTQ+ people may also experience other forms of stigma and discrimination – such as racism, sexism, poverty or other factors – alongside homophobia or transphobia, that negatively impact their ability to access healthcare services.
This is known as Intersectionality, and refers to how multiple concurrent and ongoing types of bias influence and amplify one another (i.e. racism, sexism, anti-trans bias).
For example, a transgender person might experience transphobia as a barrier to care, while a racialized and disabled transgender person might experience racism, disability discrimination and transphobia as more complex interlocking system of barriers. It is at the intersection of various social worlds where barriers to care become enhanced and made more complex.
Role of BC’s Health Professionals
The College acknowledges the negative impact of stigma and discrimination within our health system, and recognizes the need for continued training and improvement with the goal of changing attitudes toward 2SLGBTQ+ people
BC’s pharmacy and health professionals play a vital role in ensuring 2SLGBTQ+ people receive safe, effective and ethical care at all levels of our healthcare system.
2SLGBTQ+ people face a unique set of health issues, risks and challenges. It is our duty as healthcare professionals to learn about and understand these issues and to recognize the barriers faced by individuals who belong to marginalized communities in accessing equitable healthcare.
“We cannot solve the problems until we are aware of what the problems are, and as of right now, these knowledge gaps often leave a burden of education on marginalized people. The barriers faced by gender and sexual minorities are not always obvious; however, there are simple ways that health care providers can provide low-to-no barrier access to services and signal a safe and inclusive environment while doing so.”
- Bex Peterson, 2SLGBTQ+ Advocate
How can Health Care Professionals Help Remove the Barriers to Care 2SLGBTQ+ Peoples Experience?
In January 2020, Bex Peterson, a nonbinary writer, student and advocate for 2SLGBTQ+ people published an article on the College‘s website offering guidance and best practice for addressing healthcare challenges faced by the 2SLGBTQ+ community.
Below is a summarized list of Bex’s recommended best practices for healthcare professionals:
Familiarize Yourself with 2SLGBTQ+ Community Terms
2SLGBTQ+ is an umbrella term for people who identify as something other than heterosexual and/or cisgender.
Understand How 2SLGBTQ+ Identification can Impact Patient Safety and Experience
Understanding these terms is paramount for comprehending the barriers trans people in particular often come up against in health care spaces. Because of the nature of health care, providers often have access to information that can be uncomfortable or harmful for trans people, such as previous names and records of assigned gender at birth.
Healthcare workers should look to incorporate ongoing records of patient pronouns and names-in-use, rather than working off assumptions from medical records. As well, health care providers can “signal” an inclusive workplace by wearing nametags with their personal pronouns listed.
Understanding How 2SLGBTQ+ Stereotypes can Impact Patient Safety
2SLGBTQ+ people also often experience barriers with regards to assumptions. Though we have supposedly moved past identifying homosexuality as a mental illness, assumptions regarding gender and sexual minority “lifestyles” regardless of individual experiences can result in patient concerns going unheard in favour of whatever fits a stereotypical narrative.
Creating a Welcoming and Safe Environment
A welcome environment starts before a patient walks through the door. If we continue to see 2SLGBTQ+ people as aberrations from a norm, we cannot holistically shift to a workplace mindset that appropriately addresses community concerns. Any patient, any co-worker, any person one interacts with over the course of a day might be 2SLGBTQ+. It is recommended that discrimination policies are reviewed and, far more importantly, properly enforced in the spirit of ongoing education rather than punishment and policing.
Commit to Continuing to Learn
The 2SLGBTQ+ community is constantly growing and evolving. As such, 2SLGBTQ+ allyship is an ongoing learning process. Healthcare providers are encouraged to seek out self-education to remove the burden from patients. Gaps in knowledge are inevitable. However, “I don’t know” is not nearly as valuable a response to a knowledge gap as “I don’t know, but I will find out.”
Healthcare providers should treat each patient as an individual, regardless of sexual or gender identity.
Commit to Continued Learning
Health professionals need to listen to, and reflect on the experiences of 2SLGBTQ+ community members and the legacy of discrimination that continues to this day.
Explore the following resources to help make our health system more safe for the 2SLGBTQ+ community:
- Vancouver Pride
- The Health of LGBTQIA2 Communities in Canada – Report of the Standing Committee on Health
- 2020-07 Exploring Gender Diversity – Provincial Health Services Authority
- Trans Basics – Provincial Health Services Authority
- Primary Care Resources – Provincial Health Services Authority
- Clinical Speaker Series – Provincial Health Services Authority