Thank you.
I'd like to thank the committee chair and members for inviting me to speak today on LGBTQ2 health in Canada. I'd like to focus on indigenous LGBTQ2 health in Canada.
I'd like to begin by acknowledging the traditional unceded territory of the Algonquin Anishinabe people.
My name is Arthur Miller. I work with Healing Our Nations as a community health educator. We're a non-profit organization. We work in 33 first nation communities in Atlantic Canada in sexual health. It started with HIV, when we saw a need. We saw that our people were dying of AIDS. We started a task force that progressed over the years. Now, we educate on really anything that people need in their communities to live a healthy and happy life. We have different workshops on setting boundaries and on LGBTQ youth.
We do a lot of work with the youth in Atlantic Canada. We have a youth and elder gathering every year, in which we bring in about 10 LGBT indigenous youth to a gathering. We do sexual health 101. There's ceremony, and there are drumming, naming ceremonies, medicine walks and, most important, time spent in getting to know elders. Elders carry the knowledge of where we've come from and the youth will carry it on to where we're going.
This gathering has proven through testimony that indigenous LGBTQ people have gained knowledge, confidence and self-peace. Some expressed that they weren't connected to their culture but that after attending the gathering felt that there was a missing link that was replaced. It's difficult to live your life if you don't know parts of who you are. Culture is very important because it brings balance, and balance contributes to better health.
We have an APHA peer mentoring project, which reaches out to indigenous people who are newly diagnosed with HIV or affected by HIV. We see a really big need for more peer mentors. There's great value in people sharing their experiences with others who may be going through the same thing. For instance, in a community in New Brunswick, we've had youth attend our workshop who are now carrying out sexual health workshops with their peers.
This work is very important to me. I am an indigenous person living with HIV, and I saw a need for better services or more services that were specific to indigenous people.
One of the biggest challenges we see is layered stigma and discrimination. Not only do we see stigma and discrimination because people are indigenous, but we see it also because they're from the LGBTQ community and, on top of that, there may be a diagnosis of HIV or hepatitis C. Added to that is the lack of cultural competency in non-indigenous services. It's hard for some to take the step to speak to their doctors regarding LGBTQ issues for fear of discrimination, but also, at the same time, it's difficult having to explain who they are and the differences they have compared with non-indigenous people.
The knowledge of indigenous people needs to start at the top. We've made progress in educating others through cultural competency training, but we really should look at making cultural competency training a requirement in our health care services. I work closely with all of the infectious disease doctors in Atlantic Canada, and thankfully, over the years, I've been able to educate around first nations culture; however, this was done at their own will. In addition, a point was brought forward from one of our specialists, who said that they receive little to no information on transgender people.
Many front-line services understand little about indigenous people, which makes it a barrier, then, to treat them and move forward. It's frustrating not only for the patients, but for the professionals too. It's very difficult for many because their health care centres in rural areas don't have the same services and supports as urban areas. One of the issues is that they have to travel to larger cities to receive treatment that they should be able to access in their own communities.
The concern here, for example, is that a person can now get tested for HIV or hepatitis C within their community at their health care centres. We have very high rates among our LGBTQ community. But what happens is, should they test positive for HIV or hepatitis C, they are then referred to a larger facility that, in some cases, can be hours away. We're losing people between diagnosis and showing up for their first specialist appointments. There needs to be more connections and knowledge shared between community health nurses and the specialists. People don't know what they are to expect and, therefore, many times do not make follow-up appointments, which causes a decline in health, causing other health issues.
In Nova Scotia and other provinces, we're lacking family doctors. The concern is that LGBTQ2 people are forced to visit walk-in clinics. They are not comfortable doing so because there is no doctor-patient relationship. On the other hand, if they should be so lucky as to have a family doctor, they have to deal with enforced shortness of visits.
I had a colleague mention that elderly people have concerns that they may have to go back into the closet when they give up fully independent living due to possible homophobia. People want LGBTQ2 elderly assisted and co-housing. We need to work more on normalizing LGBTQ2 and help include them in everything.
Sexual health education—for LGBTQ, rather than just heterosexual health—and additionally, health centres, need to be diverse in gender diversity so that supports are in place if Healing Our Nations is not available to provide education. Also, education shouldn't be limited to just teens in schools. We need to understand that the coming-out process is different at any age.
In closing, we need to build up LGBTQ people and help them be proud of who they are and what they can contribute.
Thank you.