Health Committee on Feb. 28th, 2019

[Dr. Lori E. Ross]

I think there's a lot that can be done working through Statistics Canada. In Canada, our population-based data on sexual orientation and gender identity are greatly lacking compared to that in other countries. I feel it's a scenario in which we are quite behind. I think there's a lot of room for further development there.

I think that in getting at the issues you're talking about, we need to be able to have data at a more local level as well. That's why there's room for collaboration with other levels of government in terms of the data that they are collecting.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Do you have any specific things you know we should do?

[Dr. Lori E. Ross]

One specific suggestion would be in terms of the homelessness point-in-time counts, which are done at the municipal level. Right now, it's patchwork. Some municipalities collect data on sexual orientation and gender identity and others don't That's a specific example where having those data that are collected municipally available at a national level would be very advantageous, particularly knowing that so many LGBTQ2SQ people experience homelessness.

A food security survey is another important one, since food security is such an important issue. There too, the questions on sexual orientation and gender identity are asked in some regions and not in others.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

What are the other specific cases, outside of Canada, for which you said we're lacking those statistics specifically? What is the best of the business that can help us?

[Dr. Lori E. Ross]

Most often, we're going to U.S. datasets. That's because they ask a wide range of questions, not only on sexual identity, which is what we have so far, but also on sexual behaviour, which capture another segment of the community that may not self-identify but that may be engaging in behaviour that has implications for health. There are also questions on sexual attraction, which are really the questions we need in order to understand issues for youth, who, as you have heard, have particular vulnerabilities. For youth who may not yet be sexually active or who may not yet have decided on a sexual identity, sexual attraction is really the only way we can tap into that population.

[Devon MacFarlane]

If I can expand a little bit on that, we have one example that is strong but could be a lot stronger. Just a year ago, PHAC, in combination with StatsCan and some other partners, launched the health inequalities data tool. There are 65 indicators for health. Seventeen of them have information about sexual orientation—none about gender identity.

That tool is providing some of the best data we have so far. There are huge gaps, but there is a platform as we get these questions added in in various places. It's a game-changing tool, I think.

Another piece to this is that a lot of progress has happened in the States, particularly since 2010-11. In the States, in 2011, the Institute of Medicine, which is now called the National Academy of Medicine completed a study on LGBT health. They looked at all the research available on health in the States, just American data. Out of that, they developed an understanding of what their point in time was. They also, similar to what we've been talking about, identified all the gaps, and have put funding very strategically into addressing some of those research gaps.

If we could do something like that in Canada, it would be amazing. Some of the data I was talking about today around chronic disease prevalence is from the States, and it's been funded through those initiatives.

[The Chair, Liberal, Bill Casey]

Thank you very much.

Now we go to our five-minute round of questioning, starting with Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Mr. Chair.

Also, Mr. Chair, we have a new addition to our committee. It's MP Pam Damoff.

Could you maybe clarify what her role is here?

[The Chair, Liberal, Bill Casey]

She's our brand spanking new parliamentary secretary.

John Oliver is not running again, so he has resigned as parliamentary secretary. Ms. Damoff is our new parliamentary secretary for health.

We've already had a discussion to talk about where things are going and what the committee is up to, so she's already up to speed and fitting right in.

[Len Webber, Conservative, Calgary Confederation, AB]

Excellent.

You just took two minutes of my time, Mr. Casey. Wind it back again.

[The Chair, Liberal, Bill Casey]

I'll look after that.

[Len Webber, Conservative, Calgary Confederation, AB]

Anyway, welcome, Ms. Damoff.

Witnesses, thank you for coming here today.

Mr. Ayoub alluded to MP Randy Boissonnault and his work at the secretariat. He's the Prime Minister's special adviser on LGBTQ issues.

Have any of you dealt with Mr. Boissonnault in your daily work?

[Devon MacFarlane]

In a past role, I served as a volunteer on the board of the Canadian Professional Association for Transgender Health, and at our last conference, we had a chance to sit down and meet with him.

Through Sherbourne Health, when he was announced, representatives from our organization were able to meet with him. We had submitted a letter about some priorities around LGBT health that could be addressed. Data was one of them.

[Len Webber, Conservative, Calgary Confederation, AB]

Excellent.

[Richard Matern]

I haven't personally met with him, but Egale has, on an extensive level.

[Len Webber, Conservative, Calgary Confederation, AB]

Excellent.

Mr. Matern, in your presentation you talked a bit about the homeless shelters and how a lot of these young LGBTQ community members feel unsafe.

Do you have a recommendation on what the federal government could do with regard to making them feel safer?

I have a history with the Calgary Homeless Foundation. I served on the board for many years.

This is something that should be fixed, whether it's supervision in these shelters...which I assume that they have.

Are there any thoughts from you on that, or any of you?

[Richard Matern]

Well I think as part of the national housing strategy, there are a few streams in there that can do targeted homeless initiatives that support LGBTQI2S youth. Supporting infrastructure would be key. I think that would be one large thing.

One of the youth at our centre had mentioned that in a shelter, because they were gender non-conforming, there was no gender neutral area for them to be in. They put them in isolation, basically.

[Len Webber, Conservative, Calgary Confederation, AB]

Do you agree with isolation or separation?

[Richard Matern]

No. It's basically having a room that enables support for gender non-conforming and trans youth, so they don't have to be put in isolation.

That's an infrastructure issue, and I think that goes into part of the strategy to support shelters that provide services specifically to LGBTQI2S youth.

[Len Webber, Conservative, Calgary Confederation, AB]

Mr. MacFarlane, you mentioned that in some health care facilities too, they sort of segregate the LGBTQ seniors.

[Devon MacFarlane]

I wouldn't necessarily describe it as segregating, as much as creating space where people go, if they want to go there. It's definitely not forced, but more voluntary. This has been an approach that has also been used in some shelter contexts, especially for folks who are trans.

If they only have a men's side and a women's side, what would best fit with their gender identity and how can they make them feel safe and welcome? There's some really interesting work out there that's happening in a few cities.

[Len Webber, Conservative, Calgary Confederation, AB]

That's good. We're making progress at least.

[Devon MacFarlane]

We're making progress, yes.

[Len Webber, Conservative, Calgary Confederation, AB]

Fantastic.

I'll address this question to Dr. Ross.

First of all, I find the things that you told us today with respect to discrimination in the LGBTQ community extremely disturbing. It's very sad.

Dr. Ross, we've all talked about the attempted suicides and the depression and anxiety in that community.

I'm looking at the Library of Parliament document that we all received, and there has been no mention about the physical health with respect to the LGBTQ community. First of all, it says here that there's a high rate of arthritis among lesbian women compared to heterosexual woman, and also asthma.

Do you have any comments on that at all? I find it quite surprising that there would be that difference.

[Dr. Lori E. Ross]

Yes.

I think we're only beginning to understand those kinds of differences, because we've only started to ask those questions from the data. Particularly for conditions that have a relationship to the immune system, there's a strong argument that people's experiences of accumulated life stress associated with discrimination are likely playing a major role in those kinds of chronic conditions in later life. There's also a lot of data on sexual and reproductive health outcomes for sexual minority women where we're seeing really striking disparities.

Again, we're only starting to be able to fully characterize what's happening there. It's important to situate what's going on largely within the impact of social discrimination and what that does to someone's body over a lifetime.