General LGBT Health
In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy.
In this discussion paper, we review Canada’s contributions to the field of public health, with a particular emphasis on the failure of interventions aimed at individual behaviours or risk variables to adequately address key determinants of health for lesbian, gay, bisexual, transgender, transsexual, Two-Spirit, intersex, and queer (LGBTTTIQ)1 people. The ongoing process of defining new public health goals for Canada is used to illustrate how an intersectional approach to public health could more effectively address the social determinants of health for LGBTTTIQ people.
Concerns still exist among lesbian-, gay-, bisexual-, transgendered-, and queer-identified individuals (LGBTQ individuals) about their reception and treatment by psychiatric service providers. The Psychiatric Service at the University of Toronto and the Office of LGBTQ Resources and Programs convened a committee to address expanding the capacities of the Service related to the needs of LGBTQ and questioning students. In this paper, we describe the committee's role, initiatives, and successes and discuss challenges encountered in the process. The model of community development drawn from in this work can be adapted for use in other community health settings.
Research has demonstrated that rates of depression are elevated among lesbian, gay, bisexual and transsexual (LGBT) people as a result of social stigmatization. However, few studies have investigated interventions which address the proposed causes of depression for LGBT people (i.e., internalized and external oppression). This study tested a cognitive behavioural therapy-based group intervention for LGBT people living with depression, which was delivered based on anti-oppression principles and included sessions on coming out and internalized homophobia. Participants demonstrated statistically significant reductions in symptoms of depression, and statistically significant increases in self-esteem, following the intervention. Implications for service delivery to LGBT people are discussed.
The purpose of this study was to explore field instructors' experiences and insights in working with lesbian and gay MSW students. In-depth 1-to 1.5-hour interviews were conducted with 8 field instructors selected using purposive sampling. Data were analyzed using narrative thematic analysis and a constant comparative method. One set of themes emerged across all informants; a second set emerged exclusively from lesbian-and gay-identified informants. Dynamic interactions among the student, the field instructor–student relationship, and the agency context suggest the importance of moving beyond individual-level conceptualizations to address sexual orientation-related barriers and opportunities in field education.
This article explores the relationship between self-disclosure of lesbian/queer (LQ) sexuality and well-being and recovery as described by women who either identify as consumer/survivors of psychiatric and mental health services and/or who work as mental health service providers within hospital- and community-based psychiatric and mental health service settings. I explore the relationship between self-disclosure and well-being and recovery by examining three points that frame women's ideas and experiences of self-disclosure including: (a) The negation and dismissal of lesbian/queer sexuality as an identity, (b) the closing off or compartmentalizing of concerns by lesbian/queer women, and (c) sexuality as a potential source of stress and/or support for lesbian/queer women.
Resources for Researchers and Service Providers
- Creating Together: Developing a Mental Health and Addictions Research Agenda for Ontario - LGBT Consultation
- Asking the Right Questions 2: Talking with clients about sexual orientation and gender identity in mental health, counseling and addiction settings