2010 Qualitative Trans Needs Assessment

Comprehensive Qualitative Report of the 2010 Transaction Needs Assessment

Pink Triangle Services

Executive Director: Claudia Van Den Heuvel Co-coordinator: Andrea Waling April 7th, 2010.

Copyright © 2010 Pink Triangle Services

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT

TABLE OF CONTENTS

1.0 INTRODUCTION ................................................................................................................................ 2

2.0 STATISTICAL FINDINGS ................................................................................................................. 2 2.1 DIVERSITY ...................................................................................................................................... 2 2.2 MEDICAL ......................................................................................................................................... 3 2.3 LEGAL ............................................................................................................................................. 6 2.4 COUNSELLING AND SUPPORT ..................................................................................................... 8 2.5 LOCAL SERVICES .......................................................................................................................... 9

3.0 ANALYSIS .......................................................................................................................................... 11 3.1 DIVERSITY .................................................................................................................................... 11 3.2 MEDICAL ....................................................................................................................................... 12 3.3 LEGAL ........................................................................................................................................... 12 3.4 COUNSELLING AND SUPPORT ................................................................................................... 13 3.5 LOCAL SERVICES ........................................................................................................................ 13

4.0 CONCLUSION ................................................................................................................................... 15

APPENDIX A: KEY TERMS AS ADOPTED BY PTS .......................................................................................... 16 APPENDIX B: SAMPLES OF OTHER TRANS-NEEDS ASSESSMENTS .............................................................. 20

2

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT

1.0 INTRODUCTION The purpose of the transaction needs assessment was to evaluate what changes need to be made in Ottawa to become more accommodating for the transgender and transsexual community. Part of this was to demonstrate that we have a larger community than perceived who identify as transgender or have/had transsexual experiences. We focus on services that would be frequented largely by the Trans community as well as services that are used by the whole of Ottawa. This assessment explores the level of knowledge, culturally competency and sensitivity that these services may or may not have.

2.0 STATISTICAL FINDINGS We divided the statistical findings into five sections that correspond with the division of the questionnaire. The first section concentrates on diversity, the second on medical, the third on legal, the fourth on counselling and support, and the last on local services. For a list of terminology we use throughout this report, please see Appendix A. For an overview of other transgender and transsexual needs assessments conducted in North America in the last ten years, please see Appendix B.

2.1 DIVERSITY Most respondents identified with the categories provided within the survey. However, we left a section in which they could indicate or situate themselves in a manner that was not available through the options on the survey. In question 1 which asked for sex (biological): 35% of respondents categorized as male, 21% as female, 10% as intersexual; and 6% as transsexual. Within the “other” option, one individual identified as post-op MTF, another as trans-female and one stated “male genitalia, female breasts, on hormone treatment, classify this as you see fit”. For the second question on gender identity: 18% identified as man; 40% as woman; and 32% as transgender. For the “other” option, one individual identified as post-op MTF again, while another stated that their gender identity was transsexual. The third question concerned gender expression, where: 21% classified themselves as masculine; 32% as feminine and 40% as androgynous Two individuals identified differently; one stated they were feminine-leaning androgynous while the other was gender fluid. The last question focused on sexual orientation, where:

3

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT 4% identified as gay; 7% as lesbian; 21% as bisexual; 3% as queer; 0% as two-spirited; 7% as asexual; 7% as pomosexual; 14% as pansexual; 0% as omnisexual; and 14% as heterosexual. Two individuals identified differently, one indicated they were lesbian two-spirited while another stated that they were undecided.

2.2 MEDICAL The medical section of this survey dealt with all medical services pertaining in particular to transgender and transsexual individuals. There were 17 questions altogether for this section. For the first question which was separated into three parts, it focused on whether service practitioners should be able to provide knowledgeable, culturally competent and sensitive health services for transgender and transsexual individuals: 3% strongly disagreed on all three categories; 0% disagreed; 0% were undecided; 3% considered this question non-applicable; 39% agreed on knowledge, 32% on culturally competent and 21% on sensitive; 53% strongly agreed on knowledge, 60% on culturally competent and 71% on sensitivity.

Endocrinology

For the second question requiring access to endocrinological treatment 64% said yes; 25% said no, and 10% said I don’t know. For the third question concerning whether they believed access to endocrinological treatment was available in Ottawa or a reasonable distance from Ottawa: 50% said yes; 4% said no; 21% said I don’t know, and 25% said not applicable. The last question was similar to the first question on the survey, except it focused specifically on whether individuals felt that medical personnel in endocrinology are able to provide knowledgeable, competent and sensitive services: 0% strongly disagreed on knowledge, 3% on culturally competent and 0% on sensitivity; 14% disagreed on knowledge, 17% on culturally competent, and 21% on sensitivity; 17% were undecided on knowledge and culturally competent, and 10% on sensitivity;

4

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT 25% agreed on knowledge, 21% on culturally competent and 28% on sensitivity; 17% strongly agreed on knowledge, 14% on culturally competent and sensitivity.

Sexual Reassignment Surgey Questions 9-10 were focused on sexual reassignment surgery (SRS) and presented in the same manner as those for endocrinology. For the first question considering whether individuals felt they needed SRS: 60% said yes; 29% said no, and 10% said I don’t know. For the second on whether access to SRS was available in Ottawa or a reasonable distance from Ottawa: 25% said yes; 14% said no; 36% said I don’t know, and 25% said not applicable. For the last question on whether individuals felt that medical personnel in SRS services are able to provide knowledgeable, competent and sensitive services: 0% said strongly disagree on knowledge, 3% on culturally competent and 3% on sensitivity; 3% said disagree on knowledge, 3% on culturally competent and 0% sensitivity; 32% said undecided on knowledge, culturally competent and sensitivity; 10% said agree on knowledge and culturally competent and 14% on sensitivity; 21% said agree strongly on knowledge, and 17% on culturally competent and sensitivity, and 32% said not applicable on all three. The last six questions were concerned with affordability, transitioning/nontransitioning status and outreach. For the first one, we asked whether individuals could afford to pay for services not covered by OHIP: 43% strongly disagreed; 25% disagreed; 10% were undecided; 7% agreed; 4% strongly agreed, and 10% said not applicable. For the next three, we asked individuals concerning their transition status if they felt they could access medical services in which personnel would be knowledgeable, culturally competent and sensitive about their gender identity, expression and if applicable, their status of transition. For those not transitioning: 3% strongly disagreed on all three categories 7% disagreed on all three categories 7% were undecided on all three categories 17% agreed on all three categories 0% strongly agreed on all three categories, and

5

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT 64% said that it was not applicable for all three (indicating that they are currently, preparing to or already have transitioned) The second question which repeated the above question and altered nottransitioning to pre-transiting or had experience in pre-transition: 7% strongly disagreed on knowledge and culturally competent and 10% on sensitivity; 7% disagreed on knowledge and sensitivity, and 14% on culturally competent; 21% were undecided on knowledge, and 17% on culturally competent and sensitivity; 17% agreed on knowledge and sensitivity, and 14% on culturally competent; 3% strongly agreed on all three categories, and 42% said that it was not applicable for all three. The third question focused on individuals currently in-transition or have experienced being in-transition where: 10% strongly disagreed on knowledge and culturally competent, and 11% on sensitivity; 3% disagreed on knowledge and sensitivity, and 7% on culturally competent; 14% were undecided on knowledge and sensitivity, and 10% on culturally competent; 14% agreed on knowledge and culturally competent and 11% on sensitivity; 7% strongly agreed on all three categories, and 50% said that it was not applicable for knowledge and culturally competent, and 51% for sensitivity. The last centered on post-operative individuals where: 10% strongly disagreed on all three categories; 3% disagreed on knowledge, 7% on culturally competent and 0% on sensitivity; 7% were undecided on knowledge and sensitivity, and 3% on culturally competent; 3% agreed on knowledge and culturally competent, and 7% on sensitivity 0% strongly agreed on all three categories, and 75% stated that this question was not applicable to them in all three categories (indicating that they have not undergone surgical alteration). We finished the medical section asking respondents to indicate where they felt outreach was needed to improve knowledge, sensitivity and cultural competency in different medical services. The majority of respondents stated that outreach was needed, especially in areas such as General Practitioners (34% agree and 61% strongly agree); Endocrinologists (42% agree and 46% strongly agree); Surgeons & Surgerical Support Staff (38% agree and 34% disagree) Nursing Staff (42% agree and 38% strongly agree); Receptionist/Front of House (50% agree and 34% strongly agree); Radiologists (42% agree and 30% strongly agree) and Ultrasound Technician (42% agree and 30% strongly agree).

2.3 LEGAL The legal section of this survey dealt with all legal services. There were 13 questions altogether for this section. For the first question, we asked individuals if they knew how to access legal aid and/or a lawyer in Ottawa:

6

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT 50% said yes; 32% said no, and 18% said I don’t know. For the second, we asked whether they believed access to legal aid was available in Ottawa or a reasonable distance from Ottawa: 46% said yes; 0% said no, and 54% said I don’t know. For the third, we asked if the felt that they could contact lawyers who are knowledgeable, culturally competent and sensitive: 7% strongly disagreed on all three categories 7% disagreed on all three categories 42% were undecided on knowledge, and 39% on culturally competent and sensitivity 7% agreed on knowledge and sensitivity, 10% on culturally competent 3% strongly agreed on knowledge and culturally competent and 7% on sensitivity 32% said that it was not applicable We asked if respondents knew how to access the hate crime unit of the police department: 43% said yes 50% said no 7% said I don’t know That was followed by whether respondents felt that individuals in the hate crime police unit would be knowledgeable, culturally competent and sensitive: 0% strongly disagreed on all three categories; 25% disagreed on knowledgeable and culturally competent, and 17% on sensitivity; 21% were undecided on knowledgeable and sensitivity, and 17% on culturally competent; 25% agreed on knowledgeable and culturally competent, and 28% on sensitivity 17% strongly agreed on knowledgeable and culturally competent, and 21% on sensitivity, and 10% said that it was not applicable for knowledgeable and sensitivity, and 14% for culturally competent. When asked whether respondents were familiar with the Canadian Human Rights Commission (CHRC): 68% said yes, and 32% said no. We asked if respondents would feel comfortable reporting a violation committed to them to the CHRC: 43% said yes; 25% said no, and 32% said I don’t know This was followed by whether respondents felt that personnel in the CHRC would be knowledgeable, culturally competent and sensitive: 3% strongly disagreed on all three categories;

7

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT 10% disagreed on culturally competent and sensitivity, and 7% on knowledgeable; 32% were undecided on culturally competent and sensitivity, and 35% on knowledgeable; 21% agreed on knowledgeable and culturally competent, and 14% on sensitivity 7% strongly agreed on knowledgeable and culturally competent, and 14% on sensitivity; 25% stated not applicable on all three categories. We asked if respondents were familiar with the Human Rights Tribunal of Ontario (HRTO): 46% said yes, and 53% said no We then asked if they would feel comfortable reporting a violation against them to the HRTO: 36% said yes; 21% no, and 43% said I don’t know. This was followed by whether respondents felt that personnel in the HRTO would be knowledgeable, culturally competent and sensitive: 7% strongly disagreed on all three categories 7% disagreed on culturally competent and sensitivity, and 3% on knowledgeable 46% were undecided on all three categories 17% agreed on knowledgeable, 14% on culturally competent and 10% on sensitivity 7% strongly agreed on knowledgeable and culturally competent, and 10% on sensitivity 17% stated not applicable in all three categories We asked if respondents were confident that they could afford to pay for legal services 50% strongly disagreed; 29% disagreed; 14% were undecided 4% agreed 0% strongly agreed, and 4% said not applicable. We ended this section asking if outreach was needed to improve knowledge, sensitivity and culturally competency in legal services. 50% strongly agreed that this was needed for lawyers, police and police station front of staff, and 42% strongly agreed on legal aid receptionists.

2.4 COUNSELLING AND SUPPORT The counseling section of this survey dealt with all counseling and support services. There were 7 questions altogether for this section. For the first question, we asked individuals if they required access regarding their sexuality and/or gender, transitioning or cross-dressing:

8

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT 33% said yes to sexuality, 40% said no, 3% said I don’t know and 22% said not applicable 48% said yes to gender identity, 33% said no, 3% said I don’t know, 14% said not applicable 40% said yes to gender expression, 40% said no, 3% said I don’t know, 14% said not applicable 48% said yes to transitioning, 25% said no, 11% said I don’t know, and 14% said not applicable 18% said yes to cross-dressing, 33% said no, 7% said I don’t know, and 40% said not applicable When asked if individuals felt that access to counseling services were in Ottawa or relatively short distance from Ottawa: 58% said yes; 8% said no, and 35% said I don’t know. We asked if individuals felt that personnel working in counseling services would be knowledgeable, culturally competent and sensitive: 0% strongly disagreed on all three categories; 22% disagree on knowledgeable, 25% on culturally competent and 14% on sensitivity; 29% were undecided on knowledgeable and sensitivity, and 18% on culturally competent; 14% agreed on knowledgeable, 29% on culturally competent, and 22% on sensitivity; 29% strongly agreed on knowledgeable and sensitivity, and 22% on culturally competent, and 3% were not applicable. This was followed by whether individuals felt they could pay for counseling services out of their own pocket or a health plan: 19% strongly agreed; 22% agreed; 11% were undecided; 19% disagreed, 26% strongly disagreed, and 4% said not applicable We asked if respondents were confident that individuals working at GLBTTQ centers would be knowledgeable, culturally competent and sensitive: 11% strongly disagreed with knowledgeable, 7% culturally competent, and 3% on sensitivity 7% disagreed with knowledgeable and sensitivity, and 3% on culturally competent 14% were undecided on knowledgeable and culturally competent, and 18% on sensitivity 40% agreed on knowledgeable, 44% on culturally competent and 33% on sensitivity 22% strongly agreed on knowledgeable, 25% on culturally competent and 33% on sensitivity, and 3% stated not applicable for all three categories.

9

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT We then asked respondents if their partner needed counseling concerning their transition or cross-dressing, that they would be able to find a service that is knowledgeable, culturally competent and sensitive: 7% strongly disagreed on all three categories 14% disagreed on knowledgeable and sensitivity, and 7% on culturally competent 18% were undecided knowledgeable, 14% on culturally competent and 11% on sensitivity 11% agreed on knowledgeable and culturally competent, and 14% on sensitivity, 7% strongly agreed on knowledgeable and culturally competent and 11% on sensitivity, and 40% stated not applicable in all three categories. We ended this section asking if outreach was needed to improve knowledge, sensitivity and culturally competency in counseling services. 44% strongly agreed on community-based counselors, 32% on transition therapists, 52% on psychologists and support groups, 56% on psychiatrists and 40% on front of house staff in all establishments.

2.5 LOCAL SERVICES This section was comprised of 7 questions that focused on local services. We began this section by asking what areas needed outreach to improve knowledge, sensitivity and culturally competency. 30% to 60% of respondents agreed or strongly agreed that all services needed improvement. These areas included restaurants (56%), grocery stores (56%), community centers (52%), shopping centers/strip malls (44%), large consumer stores (48%), gay and lesbian clubs and bars (32%), straight clubs and bars (40%), movie complexes (48%), theatres (48%), sexual assault centers (48%), educational institutions (60%), postal services (40%), convenient stores (40%), adult entertainment stores (32%), daycare canters (36%), sports complexes (48%), government offices (56%), immigration services (36%), and hospital/emergency services (52%). We then asked if individuals were able to support themselves and/or access assistance if needed: 4% strongly disagreed on able to support and 0% on accessing assistance; 24% disagreed on able to support and 32% on accessing assistance; 4% were undecided on able to support and 12% on accessing assistance; 44% agreed on able to support and 28% on accessing assistance; 12% strongly agreed on both categories, and 12% said not applicable to able to support an 16% on accessing assistance. We asked respondents if they were confident presenting their current ID if asked or approached by other figures of authority: 36% strongly agreed; 24% agreed; 4% were undecided; 12% disagreed;

10

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT 4% strongly disagreed, and 20% said not applicable. We followed this question with asking respondents if they were confident using to the Ottawa public transit system: 16% strongly agreed; 36% agreed; 12% were undecided; 20% disagreed; 8% strongly disagreed, and 8% said not applicable. We asked if respondents were not confident in using services that required picture ID because their gender identity/expression did not match it and if they tried to avoid using these services when possible: 20% strongly agreed on not confident and 16% on avoiding services; 12% agreed on not confident and 16% on avoiding services; 12% were undecided in both categories; 16% disagreed on not confident and 20% on avoiding services; 12% strongly disagreed on not confident and 8% on avoiding services, and 28% said not applicable. We followed this question with asking whether respondents feared harassment or assault when using their picture ID because their gender identity/expression did not match it: 16% strongly agreed; 16% agreed; 16% were undecided; 12% disagreed; 20% strongly disagreed, and 20% said not applicable We ended this section with asking respondents if they were not confident in using services that had gender-segregation and/or avoid them when possible: 4% strongly disagreed on no confidence and 12% on avoidance; 24% disagreed on no confidence and 16% on avoidance; 0% were undecided on no confidence and 4% on avoidance; 44% agreed on confidence and 36% on avoidance; 20% strongly agreed on confidence and 24% avoidance, and 8% said not applicable in both categories. We finished the assessment with a space to allow respondents to leave their comments.

3.0 ANALYSIS OF RESULTS Our analysis of the results has been divided into six sections that correspond with the divisions of the questionnaire. There is a common theme that is central to every section, and that is respect, dignity and equality. Individuals who identify with the trans-community of Ottawa are asking for equal treatment as those of cissexuals. They are asking for sensitivity, knowledge and culturally competency surrounding their presentation of gender, their identification of gender and their experience of their own sexed bodies that are viewed differently than that of cissexuals.

11

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT

3.1 DIVERSITY The diversity section, which would appear to be straightforward, demonstrates the various ways in which individuals identify and categorize themselves. Out of all the respondents, only 6% identified as transsexual, while 21% considered themselves female and 35% male. Our selective audience for this survey was the transgender/transsexual community of Ottawa, so it is safe to assume that a majority of individuals who may have had transsexual experiences are identifying as their transitioned sex. This is problematic; if we continue to attempt to separate them into their own category, then we are relying on a biological essentialist methodology in which one must either identify as their sex assigned to them at birth or as an ‘other’. One individual stated that they were post-operative male to female, so we know that they have had transsexual experiences but are not identifying as ‘transsexual.’ The other; a transwoman, could be a cross-dresser, a post-operative male-to-female with transsexual experiences, currently in transition for operation, or an individual identifying as transgender. Within the second question, we see that individuals who may academically be grouped in one category identify quite differently. The post-operative male-to-female indicates that both their sex and their gender is MTF, and another individual stated that their gender was transsexual. Again we can see a confusion about what constitutes gender and what constitutes sex. The last two questions were more straight-forward with the responses. Individuals seem to have a much better grasp on what presentations of masculinity and femininity are as opposed to sex and gender. The last question on sexual orientation demonstrates the variety of sexual orientations that exist, the most prominent being bisexual, followed by pansexual and heterosexual. What the diversity results indicate is that Ottawa is comprised of multiple gender identities, sex, gender expressions and sexual orientations. Because of these, outreach is needed to educate services of Ottawa about these vast differences as these individuals frequent many of the necessary services such as medical and local. In particular, outreach is needed to educate about forms of gender expression, gender identities and sex that are not heteronormative.

3.2 MEDICAL Within this section, a majority of respondents indicated that they were in need in medical services that were particular to their gender expression, identity or sex. This includes endocrinological services (Hormone Replacement Therapy) (64%) and SRS (60%). Most of these respondents indicated that outreach to improve knowledge; cultural competency and sensitivity about transgenderism and transsexualism were strongly needed in not only SRS and HR therapy, but all medical services. 43% of respondents indicated that they could not afford to pay for any service not covered by OHIP.

12

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT A large percentage of respondents (between 45% and 60%) indicated that they did not experience staff personnel in most services that were knowledgeable, culturally competent and sensitive. Outreach then is necessary to improve and educate all services about gender identities, expressions and bodies that do not subscribe to heteronormative ideals. Furthermore, these services should be made available financial wise or the communities should work towards in getting these services more affordable in the same manner that other medical services are available for other individuals on OHIP so they can be somewhat affordable. SRS and HRT therapy are few spots available to be covered by insurance medical treatments as part of a transsexual diagnosis; therefore, they should be deemed as such rather than as elective cosmetic procedures. Although SRS and was reinstated in OHIP in 2009, there are very spots available which does not meet the large demand. HRT is not available through insurance. A large number of respondents (between 35% and 50%) also indicated that they are currently preparing to transition, are transitioning and/or are post-transition. This is very important, as these individuals face discrimination due to their inability to be perceived as ‘normal’ by heteronormative society, especially during transition stages. There are large fears of assault and harassment during this stage. It is imperative that medical personnel are trained in working with individuals in all stages of transition as well as individuals who choose to present a gender identity or expression that does not fall within the gender dichotomy. This is especially important for figures of high authority such as general practitioners and surgeons, as these figures are relied on.

3.3 LEGAL Within this section, we asked a number of respondents if they knew how to access forms of legal assistance as well as whether they felt comfortable doing so. In most cases, including legal aid and lawyers, the hate crime unit in the police, CHRC and HRTO, 40-60% individuals were familiar with these services and knew how to access them. Only 36-43% of respondents indicated that they would feel comfortable reporting a crime or violation committed to them to CHRC, HRTO and the police hate crime unit. Respondents indicated that outreach is needed to improve knowledge; cultural competency and sensitivity, especially in the police hate crime unit and lawyers (50%) and 79% of respondents indicated that they could not afford to pay for legal services. The assessment indicates that legal services also require outreach to improve sensitivity, knowledge and cultural competency towards gender identity, gender expression and sex. Individuals in the trans-community may be more inclined to pursue legal action if they can be assured of knowledge, cultural competency and sensitivity concerning their sex, gender expression and gender identity. Training within the police department should include a section on these three areas.

13

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT

3.4 COUNSELLING AND SUPPORT The section on counselling and support demonstrates what services are needed to aid the trans-community of Ottawa, and the improvements that still need to be made. The majority of respondents (33% to 50%) indicated that they required access to counselling and support regarding their sexuality, gender identity/gender expression, transitioning and cross-dressing. In terms of whether individuals felt that personnel working in counselling services would be knowledgeable, culturally competent and sensitive, about 22-29% indicated that they are. This is problematic, as all counselling and support services pertaining to the trans-community of Ottawa should be knowledgeable, culturally competent and sensitive. However, about 40% stated that they felt that personnel working in GLBTTQ designated services were knowledgeable, culturally competent and sensitive. About 41% respondents indicated that they could pay for counselling, while 45% stated that they could not. Like medical services, there are few spots available to be covered by insurance, in which individuals who require these services do not seek them out since they cannot afford them. Most respondents indicated that outreach is needed to improve knowledge, sensitivity and cultural competency in support and counselling services, especially psychologists and support groups (52%), psychiatrists (56%), front of house staff (40%) and community-based therapists (44%).

3.5 LOCAL SERVCICES The ability to access local services is essential for all individuals in a community. This assessment demonstrates that for many individuals who identify as transgender or have transsexual experiences, certain accessibility is limited due to the lack of knowledge, cultural competency and sensitivity. Between 30% and 60% strongly agreed that all local services are in dire need of outreach to improve knowledge, cultural competency and sensitivity. A smaller number of respondents indicated that they avoided certain services or feared using them due to the lack of knowledge and sensitivity. Part of this avoidance is directed towards any service that requires the use of a photo ID, especially for those currently in transition or presenting differently than what their ID allocates. One of our respondents commented on this, stating that

“Having the ability to have legal identification, that reflects how a trans person may present is an issue that should be looked at in depth. Myself, I am a gender fluid person, and sometimes present as female, and sometimes as male. My looks change drastically when I change gender expression. Legal identification representing both my presentations would be a

14

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT huge aid in confidence as well as self esteem when in a situation that may require legal Identification.” The other half includes the use of public washrooms. Most of these are gendered and many do not have a separate disabled access single toilet washroom, as larger buildings include a larger stall for that purpose. For what we can approve, is to begin to design washrooms that include a designated area for those who do not present heteronormatively and/or for those in the process of transitioning. This will alleviate the fears of harassment and assault in public spaces where gender segregation is used. A number of our respondents commented on this, one in particular stated that

“You know what would be cool if somehow you guys had malls put in family washrooms so we don't have to wait until we get home; because it's flabbergasting trying to figure which facility to use. Like, no matter what you're going to get made fun of or worse if you walk into the men’s or women’s.” Lastly, respondents indicated that changes need to be made within GLBTTQ designated spaces and discourses surrounding GLBTTQ identities. One respondent indicated that

“I feel that sometimes we in the TG community are treated like outcasts by the gay and straight places .To be out as a gay or les seems to be ok but not to be out as a TG in public. Social help is lacking in many areas, but the advancements have been good in the last couple of years, and we need to feel more assured that we can be accepted and treated with respect and dignity. Whereas to be Gay or Lesbian is becoming somewhat more accepted within society (as long as they present homonormatively) this is not the case for the Trans community

5.0 CONCLUSION In short, our findings indicated that outreach is needed in all the areas covered by the assessment. A large percentage have indicated that medical, legal, counselling and local services are in need of training in knowledge, culturally competency and sensitivity.

15

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT

APPENDIX A: KEY TERMS AS ADOPTED BY PTS SEX

A.K.A – Genotype

(Anatomy)

A term used to describe a person’s physical sex. It is defined by one’s genitalia (i.e., penis, vagina, testicles, ovaries etc…), secondary sex characteristics (i.e., breasts, prostate, etc…), sex hormones (i.e., androgens and estrogens), and chromosomes. A person’s sex is categorized as male, female or intersex. GENDER

A.K.A – Phenotype A term used to describe the combination of a person’s internal gender identity (as a man, a woman or gender-queer) and outward gender expression (as masculine, feminine or androgynous). Gender is a social construct, meaning, it does not exist naturally but is created. It can conform to society’s expectations of anatomy and gender congruity or transcend them. Gender can be fluid or fixed. It can be assigned or changed. GENDER

A.K.A – Sub-conscious Sex, Sexual Identity

IDENTITY

Is the first of the two aspects which make up gender. Our gender identity is our own sense or conviction of being a man, a woman or gender-queer (both or neither). Most people have a gender identity which is congruent with their physical sex, however, some do not. GENDER EXPRESSION Is the second of the two aspects that make up gender. Gender expression is the outward manifestation of our gender identity. However, some people do not have an expression in alignment with their identity (within a medicalized model, this is called Gender Dysphoria or Gender Identity Disorder). It is how we present and interact with the world around us. Gender expression is defined by the mannerisms we use, the roles we take, and how we dress. It is how we represent our behaviour as masculine, feminine or androgynous. TRANS An umbrella term used to describe people who display any type of gender diversity or undergo gender and/or sex transition.

16

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT TRANSGENDER A term used to describe a person whose gender identity and gender expression do not permanently align with their physical sex based on society's expectations that gender and physical sex should be congruent. TRANSSEXUAL A term used to describe a person who identifies/lives as the gender opposite to their birth sex, and will usually seek (or desires to seek) medical intervention (such as Hormone Replacement Therapy, Sex Reassignment Surgery, etc…) and/or alter their physical appearance to align their physical sex to their gender. GENDER-QUEER An umbrella term for people with gender identities that do not fit the gender binary of masculine and feminine. While gender-queer identities vary, the most commonly used are; being both a man and a woman, being neither a man nor a woman, or as a gender outside man and woman (a third gender). The one commonality that unites all gender-queer people is their rejection of the notion that there are only two genders. TWO-SPIRIT A term used to describe Aboriginal people who fulfill one of many mixed gender. Traditionally the roles included wearing clothing, and performing the work of any gender. The term usually implies a masculine spirit and a feminine spirit living in the same body. GLBTTQ An acronym used to identify people of the gay, lesbian, bisexual, trans, twospirit and queer communities. QUEER The literal definition of the term 'queer' is synonymous with being different and originally held negative connotations. The term was reclaimed and is now used to describe all people who do not fit into a hetero-normative model. SEXUAL ORIENTATION A term used to describe the direction of a person’s emotional, intellectual, spiritual and/or physical attraction toward members of the same, opposite, or all genders. This includes; Gay, Lesbian, Bisexual, Asexual, Pansexual, Pomosexual and Omnisexual orientations. HOMOSEXUAL

17

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT A term used to describe a person who is attracted (emotionally, intellectually, spiritually and/or physically) to another person of the same gender. This is often referred to as a same-sex relationship, attraction, or partnership. However, it should be noted that the use of sex in this term is inaccurate as gender determines orientation, not physical anatomy. GAY A term used to describe a person who identifies as a man and has (or desires to have) emotional, intellectual, spiritual and/or physical relations with another self-identified man. With less frequency, the term gay is used to describe all people who do not fit a heterosexual orientation or as a designation of the rainbow community. It should be noted that this term when used as an umbrella term, excludes, silences and further marginalizes the rest of the rainbow community. MSM (men who have sex with men), MLM (men loving men) Men who engage in sexual activities with other men but may not identify as gay/bisexual/bi-curious/or queer LESBIAN A term used to describe a person who identifies as a woman and has (or desires to have) emotional, intellectual, spiritual and/or physical relations with another self-identified woman. WSW (women who have sex with women, WLW (women loving women) Women who engage in sexual activities with other women but may not identify as lesbian/bisexual/bi-curious/or queer BISEXUAL A term used to describe a person who has (or desires to have) emotional, intellectual, spiritual and/or physical relations with someone of the same or other gender. BI-CURIOUS A term used to describe a person who has a persistent desire to have emotional, intellectual, spiritual and/or physical relations with someone of the same or another gender. QUESTIONING A term used to describe a person who is unsure of their orientation and/or gender identity. INTERSEX (Disorders of sex development)

18

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT A term used to describe people who were born with a combination of male and female anatomy. This can include a combination of genitalia, secondary sex characteristics, hormones and chromosomes. A person who is intersex will most often identify as a man or a woman. However, their gender identity is not always in alignment with their predominant sex. ASEXUAL A term used to describe a person who has no apparent sexual attraction, but may desire to have emotional, intellectual, spiritual relations with another person. It should be noted that there are varying biological and psychological reasons for a person to identify as asexual, which may include; dissatisfaction with one’s genitalia, psychological barriers to intimacy and intercourse, and/or having no sexual attraction towards others. PANSEXUAL A term used to describe a person who has (or desires to have) emotional, intellectual, spiritual and/or physical relations with another person, regardless of sex, gender identity or gender expression. POMOSEXUAL A term used to describe a person who rejects the use of labels which identify orientation, gender identity or gender expression. OMNISEXUAL A term used to describe a person who is attracted to all things, including; people, animals, inanimate objects etc… MONOGAMOUS: A term used to describe a person who has (or desires to have) emotional, intellectual, spiritual and/or physical relations with one partner at a time. POLYAMOROUS: A term used to describe a person who has (or desires to have) emotional, intellectual, spiritual and/or physical relations with multiple partners at a time. HETERONORMATIVE: A term used to describe the marginalization of lifestyles that do not conform to societies expectation of congruity between physical sex and gender. Instances of this include the idea that people fall into two distinct categories of sex (male and female) or gender (man and woman), that sexual and marital relations are “normal” only between people of different sexes and only with one committed/married partner at a time, and that each sex has certain

19

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT “normal” roles in life. The hetero-normative view is that physical sex, gender identity, and gender expression should always align to either all-male or allfemale cultural norms. With Heteronormativity comes privilege and assimilation. It stigmatizes anybody in society that deviates from this model and is often the cause of societies’ perception of abnormal, immoral, illegitimate, and ultimately unworthy in another human being. HOMOPHOBIA Homophobia is the irrational fear, aversion to, or discrimination against a person or group of people, based on their perceived or disclosed orientation(s) as homosexual, or as internalized homophobia in oneself. Homophobia exhibits itself socially; as fear of knowing, befriending, or associating with people who are homosexual or perceived to be homosexual. It exhibits itself institutionally; by refusing to provide homosexuals access to services that are provided to heterosexuals, providing services differently to people who are homosexual (or perceived as homosexual) than to people who are heterosexual, or actively rejecting their rights and equal treatment to those of the heterosexual public.

APPENDIX B: SAMPLES OF OTHER TRANS-NEEDS ASSESSMENTS 1) TRANS LEGISLATIVE NEEDS ASSESSMENT April 2004, masters for social work at Carleton University Worked in conjunction with Transgender Canada, the Ethics Institute of Canada, Gender Mosaic and Egale Canada By: Chris Boodram and Corie Langdon http://www.egale.ca/index.asp?lang=E&menu=34&item=998#_TOC49 This needs assessment was based on current legislature up to 2004 in Ontario involving law and human rights for transsexual/transgender persons. It focuses specifically on violence, abuse, harassment laws, hate propaganda and hate crimes. Its research objective was to find what transsexual/transgender persons need in terms of legal changes and protection from above mentioned harassment/violence, concentrating on human rights and discrimination in social institutions such as employment, education, housing, medical, financial and support systems using a quantitative research method. The specific questions were: 1) What is the Ottawa trans community’s experience of violence, discrimination and harassment? How does the trans community understand these experiences? 2) What are the needs and priorities of the Ottawa trans community with respect to legislative and policy reform to address these experiences? This assessment separated its data into three categories that people self-identified with based on their set definitions: 1) Transsexual 2) Transgender 3) Ally It uses statistical methods of quantitative data collection with a strong emphasis on objectivity, providing credible results. It also accounts for variance and inference. What this

20

COMPREHENSIVE QUALITATIVE REPORT OF THE 2010 TRANSACTION NEEDS ASSESSMENT assessment did was work with three well known agencies that have established contact with Trans-communities. The data collection cannot be a random selection due to the nature of the study (many transsexuals choose to be ‘stealth’ or remain hidden within the community. It also arranged a a pre-test with members of the community in order to make sure the questionnaire was valid. This test was to make sure that: 1) It was culturally sensitive 2) That it made sense to members of the community 3) Questions cover a range of issues 4) Questions cover a range of priorities 2) TRANS REALITIES: A LEGAL NEEDS ASSESSMENT OF SAN FRANCISCO’S TRANSGENDER COMMUNITIES 2003 San Fransico, CA Pride Law Fund and the Echoing Green Foundation, the National Center for Lesbian Rights and the Transgender Law Center By: Shannon Minter and Christopher Daley www.transgenderlawcenter.org/trans/.../Trans%20Realities%20Final%20Final.pdf This needs assessment was focused on trans-communities in San Fransico, focusing on legal rights and discrimination. It analyzes legislature surrounding these issues up to 2003. Its research objective was to discover the legal challenges in the transgender/transsexual gender identity expression and understand the understand needs and priorities of the community. It used both a quantitative and qualitative methodological approach. This assessment discovers and categorizes the priorities are and the challenges Trans persons face into four sections: 1) Areas of Discrimination 2) Respondent Priorities 3) Health and Wellbeing 4) Recommendations 3) THE WASHINGTON, DC TRANSGENDER NEEDS ASSESMENT SURVEY 2000 Washington, DC. Gender Education and Advocacy, Principal Investigator and Consultant to Us Helping Us, People Into Living, Inc. Funded by the Administration for HIV/AIDS of the District of Columbia Government Donald A. Jones, MD et al. www.glaa.org/archive/2000/tgneedsassessment1112.shtml This assessment was a comprehensive study of the needs for the trans-community of the United States. It uses both quantitative and qualitative research and is divided into a number of sections that cover all the needs of individuals who identify with the transcommunity. It covers: 1) Transgender Health Care 2) Substance Abuse and Suicidal Ideation/Attempts 3) HIV/AIDS Knowledge, Testing & Status 4) HIV Seropositive Participants and HIV/AIDS Services 5) Sexual Risk Behaviors 6) Housing Issues 7) Self-perceived Needs This assessment is very comprehensive and acknowledges that further research is necessary.

21