I appreciate that background research.
There are a couple of things. One of the barriers is being out to your health care provider. As I said, we have research outside of Vancouver that shows us that in smaller communities up north, upwards of 60% of people are not out to their health care provider. If you're not out, you're not getting the kind of services you need, much less prevention tools for HIV, because you wouldn't be considered high-risk for HIV.
That's one thing. I think that, through cultural competency, having health care providers ask the right questions, making them seem open, is certainly one way to deal with that.
Then there's the pervasive stigma. A health care provider can be as open and competent as possible, but if the individual feels that their sexuality or their sex life is somehow inappropriate because of something they experienced as a child or as youth, bullying or all of this trauma that we know happens at a very young age in queer people's lives, it impacts their ability to come out and to live freely later in life. Certainly those upstream barriers are really important.
I know it's not a federal jurisdiction, but we have a real problem with sex education in schools in this country where queer students are not learning about their sexuality. They're learning from porn, and that's not the place where we want young people learning about sexuality.
With regard to other upstream factors around violence or childhood trauma, we need to invest in the types of programs that would ensure that, by the time people are at their sexual debut and ready to make those decisions, they're able to either come out or at least acknowledge that their sexuality is at risk.