SOUTH ASIAN TRANS PEOPLE IN TORONTO: Issues

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SOUTH ASIAN TRANS PEOPLE IN TORONTO Issues
SupportsRupert Raj, M.A., Counseling
PsychologyLGBT Counsellor (Psychotherapist)
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MENTAL HEALTH ISSUES

• Low Self-Esteem
• Despair
• Depression
• Anxiety
• Anger
• Substance Use
• Poor Body Image
• Eating Disorders

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MENTAL HEALTH ISSUES (contd)

• Self Harm
• Suicidality
• Trauma (emotional, physical, sexual, war)
• Psychiatric Conditions (Axis I/II)
• Social Isolation
• Socioeconomic Issues (poverty, housing)
• Family Problems
• Relationship Problems

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TRANS-SPECIFIC ISSUES

• Transphobia
• (discrimination, harassment, abuse, assault)
• Transqueerphobia
• (transqueers lesbian/bisexual/pansexual
  transwomen gay/bisexual/pansexual transmen)
• Genderqueerphobia
• (genderqueers transcend normative gender binary)

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RACE-SPECIFIC ISSUES

• Multiplicity of Issues from Various Sectors
• Racism (external/internalized)
• Transphobia (external/internalized)
• Homophobia (external/internalized)
• Familial Estrangement
• Religious Oppression
• Ethnoracial Stigmatization
• LGBT Community Discrimination
• Settlement Issues (immigrants/refugees)

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SHC TRANS-SPECIFIC ISSUES

• Gender Dysphoria (Gender Identity Disorder)
• Gender Identity Conflict
• Gender Identity Confusion
• Impoverished Self-Esteem
• Negative Body Image
• Transitioning
• Pre-Transitional Issues
• The Transitional Process
• Post-Transitional Issues

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SHC TRANS-SPECIFIC ISSUES (contd)

• Transitioning
• Identity Management
• Disclosure Management
• Medical, Counselling Legal Resources
• Trans-Peer Other Community Supports
• Electrolysis Treatments
• Hormone Replacement Therapy
• Sex-Reassignment Surgery
• Relationships re Family, Friends, Partners,
  Co-Workers
• Job/Career Change

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SHC TRANS-SPECIFIC ISSUES (contd)

• Sexual Identity
• Potentially Trans Clients Confusing or
  Conflicting Sexual Identity with Gender Identity
• Trans-Identified Clients Exploring Sexual
  Identity
• Transqueer Identity
• Transpeople who identify as lesbian, gay,
  bisexual, transensual /or polysexual, who are
  out or in stealth

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SHC TRANS-SPECIFIC ISSUES (contd)

• Genderqueer Identity
• Fluid identification presentation where gender
  identity intersects with sexual identity in a
  non-binary paradigm
• Multiple challenges experienced by these mostly
  young people at home, at school, at work, in
  society often in trans queer communities,
  when trying to access hormones surgery

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COMMUNITY RESOURCES

• Alliance for South Asian AIDS Prevention
• hoping to start group for trans people
• Salaam
• men transmen (suspended but still social
  events)
• women trans women trans men
• Asian Community AIDS Services
• Transgender Women Outreach Project
• 519 Church Street Community Centre
• trans peer-support groups

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CLINICAL RESOURCES

• Mental Health HIV
• David Kelley Services (Family Services
  Association of Toronto)
• Sherbourne Health Centre
• Sexual Health
• Hassle-Free Clinic
• AIDS Service Organizations (ACAS, ASAAP,
  BLACKCAP)

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SHERBOURNE HEALTH CENTRE

• Community-based health care centre located in
  central southeast Toronto opened in September
  2002
• Targets 3 primary client populations
• Homeless/Underhoused People
• Newcomers (Immigrants/Refugees)
• LGBT Community (approx. 50)
• (Trans Clients (approx. 9))

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SHC EMPLOYEE REPRESENTATION

• Overall Staff Complement
• 94 (68 F/T, 8 P/T, 18 casual/relief staff)
• LGBT Employees
• not tracked but approx. 1/3 of overall staff
• 5 trans-identified staff
• 2 queer psychotherapists (incl. 1 trans)
• 5 queer physicians
• 3 queer nurses
• People of Colour/South Asian Employees
• not tracked for overall staff
• 3 South Asian psychotherapists
• 3 other P.O.C. psychotherapists
• 1 South Asian (gay) physician
• 1 P.O.C. LGBT physician

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SHC TRANS NEWCOMER CLIENTS

• LGBT Clients approx. 50
• Trans People approx. 8
• (380-465 out of 6291)
• Newcomers 8.4
• (526 out of 6291)
• People of Colour unknown
• People Living with HIV unknown

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SHC TRANS CLIENTS

• Demographic Profile
• Transsexual, Transgender, Genderqueer, 2-Spirit,
  Intersexed
• Age Range 14-66 years
• People of Colour (? South Asian)
• Immigrants/Refugees
• Sex Workers
• Physical/Emotional Disabilities
• Poor/Low Income
• Homeless/Underhoused
• Trauma Survivors

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SHC TREATMENT APPROACH

• Interdisciplinary Collaborative Care Model
• Client-Centred
• Collaborative Relationship
• Informed Consent
• Interdisciplinary Teams
• Anti-Oppression Framework
• Trauma Framework

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SHC PROGRAMS SERVICES

• General Primary Health Care
• General Mental Health/Counselling Services
• Comprehensive Primary Health Care for Lesbian,
  Gay, Bisexual, Transgender and Transsexual
  Communities
• Supporting Our Youth (LGBT-specific)
• Mobile Health Care (Health Bus)
• Infirmary
• Community Chiropractic Clinic
• Community Naturopathic Clinic for People Living
  with HIV/AIDS

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SHC TRANS-INCLUSIVE TRANS-SPECIFIC SERVICES

• Primary Health Care
• General Physical Health
• Sexual Health
• Hormonal Therapy
• Assessment (medical history, bloodwork, referral
  re consultation with counsellor /or psychiatric
  assessment, as indicated)
• Prescription
• Administration (injections for transmen/FTMs)
• Monitoring/Follow-Up

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SHC TRANS-INCLUSIVE SERVICES (contd)

• Mental Health Care
• Individual Counselling
• Couple Counselling
• Family Therapy
• Group Work
• Walk-in-Therapy Clinic
• On-Site Psychiatric Consultation

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TRANS-INCLUSIVE TRANS-SPECIFIC SERVICES
(contd)

• Groups
• Outside the Lines (expressive arts group for
  isolated lesbians, bi trans women)
• Mens/Womens Communications Group (respectively)
• Gender Journeys (psychoeducational group for
  people considering transitioning to other gender)
• Transceptance (community-based, peer-support
  group for parents of trans children)

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SHC TRANS-INCLUSIVE TRANS-SPECIFIC SERVICES
(contd)

• Workshops
• Trans Health Project
• Towards A Transpositive Therapeutic Model
• For Parents Family Members of Transpeople
• Releasing Rage through Boxing
• Hormone Therapy for Transpeople
• For Transpeople of Colour Two-Spirit Peoples
• For Transpeople their Partners
• Special Events
• Annual Trans Pride Day
• Queer Health Matters (annual fair)
• South Asian Heritage Day

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SHC TRANS-SPECIFIC SERVICES

• Information/Consultation
• Consultation for clients/patients providers
• Community Health Initiatives
• Health promotion, prevention education
• Research projects (SHC Infirmary OPHA Trans
  Health Project focus groups, respectively)
• Research page included on our webpage
  www.sherbourne.on.ca

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SHC TRANS-SPECIFIC SERVICES (contd)

• Community Partnerships
• Trans Pulse Project (community-based research
  project)
• Rainbow Health Network Trans Health Lobby Group
• Advocacy
• Letter advocating Ontario Ministry of Health to
  re-enlist sex-reassignment surgery, etc.

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HOW TO CONTACT US

• Mailing Address
• Sherbourne Health Centre
• 333 Sherbourne Street
• Toronto, Ontario M5A 2S5
• Phone Number [phone]
• Fax Number [phone]
• Website www.sherbourne.on.ca
• Rupert Rajs E-Mail rraj_at_sherbourne.on.ca