Evidence of meeting #137 for Health in the 42nd Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was trans.
A recording is available from Parliament.
Winnipeg Centre, Lib.
Thank you very much, everyone.
The federal government's been investing in health accord agreements, and in Manitoba, for instance, it's $399.6 million for mental health and for home care. You also discussed the whole concept surrounding re-closeting in nursing care.
I was wondering if you would recommend that health transfers should also contain a section on LGBT2Q rights and considerations concerning those health accords.
Director, Rainbow Health Ontario
Absolutely, I would strongly recommend that there be some earmarked funding and earmarked deliverables around that. Particularly around LGBT seniors, and also for younger folks who are dealing with disabilities, far more will interact with home care than will necessarily interact with long-term care facilities.
I remember having a conversation with home care case managers some years ago. They were asking, “How do I even broach this?” The particular case manager I was talking to was a lesbian, and she was saying, “I'm seeing these seniors who I'm darn sure are a couple, but they're not framing themselves as a couple. They're saying that they're roommates.”
They were going in because there were health concerns, and one of them was becoming frail. They didn't have legal status, and they weren't going to have legal status because they weren't claiming to be a common-law couple, which then had a lot of impact in terms of whether they would be eligible for survivor benefits. There were also questions about what would happen about substitute decision-making. This lesbian home care provider didn't know how to open those conversations.
There's a lot of vulnerability in home care as well as long-term care. There are particular issues again for transpeople about what questions you have to ask. If you have to provide very personal care, help them with bathing and toiletting, and somebody's body may not be what's expected, how do you do that really sensitively and respectfully? Again, these are areas where there's a lot of fear, and a lot of possibility for improvement and for good care with support.
February 28th, 2019 / 5:20 p.m.
Liberal
Liberal
The Chair Liberal Bill Casey
Ordinarily parliamentary secretaries don't ask questions, but this is a special case.
I told you this was an interesting committee.
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
Oh, I had no doubt.
I have a question about medications, dosages and research. We know that not that long ago—and I think it's still happening—research would be done on a 200-pound man and then the dosage would be adjusted for a woman based on weight. That's starting to change, but I'm wondering if there are gaps when it comes to LGBT.
In particular, I'm thinking of trans individuals who are on hormone therapy or of someone who might be on the HIV cocktail. Is there any research that's been done to see whether, say, someone's heart medication is going to be effective based on those other medications the person might be taking?
Director, Rainbow Health Ontario
That's a really good question.
From my understanding, I don't know exactly what's happening. It's coming up in terms of what should be prescribed, but it's also coming up in terms of what lab values we should be looking for, because that's a little different, too, and it's often based on sex assigned at birth rather than what's going on in somebody's organ system.
There are definitely some areas for exploration and really teasing out what is going on right now. I'm sorry that I don't have a more fulsome answer, but I can try to get one.
Associate Professor, Dalla Lana School of Public Health, University of Toronto
Perhaps I could add, though, that there is almost no research that's looked at this. There's a real lack of medical research on investigating what the long-term health outcomes even are for transpeople who have particular interventions or are using particular medications, much less the questions you're asking about drug interactions or appropriate dosing. There is just an enormous need for research in those areas.
Board Member, Toronto Pflag
Perhaps I could just add that when my own son was starting this journey, my mother said to me, “What are the health risks of him starting hormone therapy?” I said, “The health risks of him not starting hormone therapy are a lot greater, and we'll probably find out down the road as they do more research.”
Liberal
The Chair Liberal Bill Casey
Thank you very much, everybody. Thanks to the committee, and thanks to the witnesses for starting us off on this little journey that I think is going to be most interesting. I hope it's beneficial to everybody by the time we're done.
Thanks again, everybody.
The meeting is adjourned.