LGBTIQ Youth Health Needs

Whakawhanaungatanga

• Who are you?– Where are you working in Aotearoa New Zealand?– What’s your work focus?– Knowledge of LGBTIQ community?

What we do• Building Pathways – biennial national hui.• E-updates to members. • Youth Week.• Training database.• Clearing house of resources. • External supervision database.• Queer/trans grants.• Strategic relationships with government and NGOs.• Code of Ethics.• Te Hautaki – alternate biennial regional hui.• Position statements.• Sector survey - Braided Pathways and Stepping Stones• Feasibility of professionalisation of youth work

Kaupapa, Mission and Strategic Goals

Kaupapa• Mō te oranga o ngā taiohi ma ngā kaitiaki e mahi ana mō rātou. For

the wellbeing of taiohi and all the people who support them.Mission• To support people who work with young people, and thereby

enhance youth development so that young people thrive.

• Nga Rourou o Ara Taiohi: Connect the Sector – Whakawhanaungatanga (foster nationwide movement of people and entities)

• Nga Kete o Ara Taiohi: Raise the standards – Whakamanatanga (professionalisation and accountability of practice)

• Te Korowai o Ara Taiohi: Champion Youth Development – Taiohitanga (co-ordinated voice on issues)

• Te Waikawa o Ara Taiohi: Promote Sustainability - Rōnakitanga

What makes us unique

• Spread of membership across a wide range of services and focuses.

• National sector voice, not limited to one area of the sector.

• Service delivery is not the primary focus.• Training database, resource clearing house,

supervision database.• Co-ordinator of Youth Week.• Code of Ethics.

Context: Queer/Trans Grants

How we know what we know:

• Cultural competency to ensure project effective – Project Leader from Queer/Trans youth work

sector– Cultural supervision

• Three Ara Taiohi community hui with Queer/Trans groups and youth

• Attending other community events and hui• SNAPSHOT – survey of grant applicants

Queer and Trans* 101, Sam Orchard, Human Rights Commission

Queer/Trans Context

• Sexuality and gender diversity– Table exercise – who does this include?– akava’ine, asexual, bisexual, fa’afafine, falafifine,

FtM, gay, genderqueer, intersex, leiti, lesbian, mahu, MtF, pansexual, queer, rainbow, takatāpui, tangata ira tane, tongzhu, trans,* transmen, transwomen, transgender, transsexual, vakasalewalewa, whakawahine

– Sometimes “LGBTIQ” attempts to cover this diversity

Sexuality and Gender Diversity

I can talk about my partner anywhere, and not worry about how people will react.

I can talk about my gender identity anywhere, and not worry about how people will react.

Homophobia, Biphobia, Transphobia

• Australia study of 3,800 LGBTIQ people:– Nearly half people surveyed hid sexuality or gender

identity in public– One third hid sexuality or gender identity when

accessing services• Why do people hide their sexuality or gender

identity?• Strategy to avoid discrimination, stigma, social

exclusion and isolation - fear

Impacts on health

• Table exercise – what are the health impacts of homo/bi/transphobia?

• Mental health disparities –depression, anxiety, eating disorders, suicide and self-harm

• Impacts on physical health – higher rates of smoking, alcohol use

• Distinct and different health needs in relation to sexual health and gender transition related healthcare (hormones, surgery)

LGBTIQ Frontline Services

What LGBTIQ Frontline Services Manage

Working together

• Half LGBTIQ groups collaborate with youth health services– Some embedded in service– Case management– Referrals

• But only 5 of 22 train local health providers– Understanding sex, sexuality and gender diversity– More inclusive services– One-to-one mentoring

Frontline LGBTIQ experience

• Research and strategic plans leave LGBTIQ youth out – needs are invisible

• Mainstream youth services rely on the LGBTIQ sector – dangerous because of burnout

• No Ministry of Health level best practice guidelines for LGBTIQ healthcare – and no accountability

• Key issue – healthcare services not required to be trained in LGBTIQ health needs so cultural safety is compromised

The LGBTIQ Youth Sector said:

• “LGBTIQ health needs are invisible”• “Humiliating”• “Disempowering”• “Inappropriate responses”• “Not respectful”• “Little knowledge around sexuality and gender”• “Inadequate treatment”• “Unsafe”

Expanding on cultural competency

• “Cultural competency is about understanding and learning to communicate with people from cultures other than our own. While many people within professional mental health and suicide prevention organisations may be aware of cultural competency they may not have considered LGBTIQ people as a distinct cultural group with particular needs and experiences.”LGBTI National Health Alliance: Cultural Competency Implementation Framework 2013, Australia

Expanding on cultural competency

• “LGBTQ cultural competency training has been developed and implemented to improve healthcare and social service delivery to LGBTQ patients and clients and, therefore, decrease LGBTQ health disparities.”

Best Practices in Creating and Delivering LGBTQ Cultural Competency Trainings for Health and Social Service Agencies, National LGBT Cancer Network, USA

• How can health services show LGBTIQ health consumers they are welcome?– Is this happening in your organisation right now?

• How can health services keep up with sex, sexuality and gender diversity issues?– Is this happening in your organisation right now?

• How can health services ensure they use correct pronouns for gender diverse health consumers?– Is this happening in your organisation right now?

• What is ONE action you will take back to your organisation to improve LGBTIQ cultural competency?

The stakes are high

Youth 2000 Research Series

Resources• “To Be Who I Am” – Report of the Inquiry into Discrimination Experienced by

Transgender People, Human Rights Commission 2008• “Non-heterosexual Youth - A Profile of their Health and Wellbeing: Data from

Youth2000”, University of Auckland 2004• National LGBTI Health Alliance http://lgbtihealth.org.au/ • “Cultural Competency Implementation Framework: Achieving Inclusive Practice with

Lesbian, Gay, Bisexual, Trans and Intersex (LGBTI) Communities” - National LGBTI Health Alliance 2013

• Leonard, W., Pitts, M., Mitchell, A., Lyons, A., Smith, A., Patel, S., Couch, M. and Barrett, A. (2012). Private Lives 2: The second national survey of the health and wellbeing of gay, lesbian, bisexual and transgender (GLBT) Australians.

• “Rainbow Communities and the New Zealand Suicide Prevention Action Plan” – SPINZ 2013

• Going upstream: a framework for promoting the mental health of lesbian, gay, bisexual, transgender and intersex (LGBTI) people, William Leonard and Atari Metcalf 2014

http://www.arataiohi.org.nz/