Vancouver Island Transgender Needs Assessment matthew heinz, phd Royal Roads University 14 January 2012

Thank you! This study has been made possible by the generous contributions of trans participants and providers as well as the members of the Advisory Board on Vancouver Island & the members of the TransPULSE Ontario project. The support of Royal Roads University is equally appreciated. Special thanks to Research Assistants T. J. Naven and Jordan Duffy.

Research Questions What are the needs of trans individuals and communities on Vancouver Island? From the perspective of trans individuals, to what degree are these needs being met?

Study Compiled overview of resources on island Assembled advisory board of community members and local experts to design community-driven study Administered survey adapted from TransPULSE Project to 54 trans participants Conducted in-depth narrative interviews with 40 trans participants (sample overlap) Conducted 10 interviews with providers

Survey Participant Profile All participants identify as ‘trans’ and range in age from 18 to 68 (Mean: 40) 28 of the participants (51.85%) were assigned to the female sex at birth and identify on the transmasculine spectrum 26 of the participants (48.10%) were assigned to the male sex at birth and identify on the transfeminine spectrum

Ethnicity 36 participants (66.60%) are of British, European, or British and European descent. 6 participants (11.10%) are of Aboriginal descent 5 participants (9.25%) are of East or South Asian heritage. Reflects, broadly speaking, Vancouver Island ethnic distribution % live in Greater Victoria Area.

Gender Identity 33.30% identify as boy or man 33.30% identify as girl or woman 27.75% identify by a self-provided label 25.90% identify as MTF 25.90% identify as Trans Girl or Trans Woman 25.90% identify as Trans Boy or Trans Man 20.35% identify as FTM 66.66% of all participants identify as the gender/sex opposite from the assigned sex; 33.34% identify with a trans-identifying label

Sexual Orientation The majority (59.20%) selected more than one label to describe their sexual orientation. TotalTransFemTransMasc Queer40.70%12.95%27.75% Straight24.05%7.40%16.65% Lesbian22.20%18.50%3.70% Not Sure22.20%7.40%14.80% Bisexual20.35%14.80%5.55% Pansexual18.50%9.25% Gay14.80%3.70%11.10% Two-Spirit12.96%7.40%5.55% Asexual1.85%0

Education Majority (70.30%) have graduated from a college or trade school, studied at university, or graduated from university with bachelor’s or graduate degrees. 26

Income Majority (62.90%) have a personal income of $30,000 or less. Income ranges from $2,500 to $150,000. Mean: $32,415. Mode: $12,000 Median: $22,000 BC 2009 median income $27,970 Average Victoria $37,065 (2006) Transfeminine participants reported higher income

Employment History Has being trans affected your employment history?

Sex Work The majority reported not ever having done sex work or exchanged sex for money or other resources.

Health Almost half of the respondents reported no (other) health conditions.

Health Issues Of the 29 participants who reported health issues, they declared (11 reported more than one condition):

Health Care Delivery Majority (85.10%) have a family doctor. The majority of those who have a regular family doctor are comfortable or very comfortable discussing their trans status and trans-specific health care needs with their doctor (87%). Majority (75.85 percent) trust physicians mostly or completely in regard to confidentiality. Majority (59.20 percent) would feel uncomfortable or very uncomfortable discussing their trans status and trans-specific health care needs with a doctor they did not know.

Emergency Health Care Delivery Majority (81.4%) have either not needed ER care or not avoided it due to trans status. Of those who have sought ER care (68.51%), the majority (72.97) report not experiencing negative behaviours from ER care providers. Almost half (45.95%) of those who have sought ER care report having had to provide education about trans issues to providers.

Mental Health Care Access Mental health care services requested most frequently for reasons other than gender identity are social worker/counselors and support groups. Mental health care services requested most frequently for reasons related to gender identity are support groups, psychologists, and social worker/counselors.

General Life Satisfaction Majority (68.45%) are either somewhat or very satisfied with their life in general.

Attitudes Toward Self On the whole, I am satisfied with myself. Agree/Strongly Agree87% I have a number of good qualities. Agree/Strongly Agree96% I am able to do things as well as othersAgree/Strongly Agree87% I’m a person of worth equal to others.Agree/Strongly Agree92% I take a positive attitude toward selfAgree/Strongly Agree76% At times I think I’m no good at all.Disagree/Strongly Disagree63% I don’t have much to be proud of.Disagree/Strongly Disagree76% I wish I could respect myself more.Agree/Strongly Agree67% I certainly feel useless at timesAgree/Strongly Agree56% All in all, I feel I’m a failure.Disagree/Strongly Disagree80% Majority consistently report positive attitudes toward self.

Experience of Violence Four participants (7.40%) have experienced physical violence and/or sexual assault due to being trans. Majority of participants (92.6%) did not. Five participants (9.25%) have experienced physical threats due to being trans. Majority of participants (90.75%) did not % have experienced verbal harassment % have experienced silent harassment.

Life After Transition Majority (86.95%) of participants have transitioned socially and/or physically and report (66.65%) that their quality of life has gotten somewhat (37.77%) or a lot (28.88%) better since.

Life After Transition Participants who have transitioned report that their number of close friends has decreased (37.77%), stayed the same (37.77%) or increased (24.44%).

Trans-Related Stress Majority (68.45%) find the amount of stress in their life specifically related to being trans a bit, quite a bit, or extremely stressful (micro-stressors).

Social Isolation About half of the respondents (49.99%) feel socially isolated most or all of the time.

Social Isolation Participants often hear that they are not normal.

Community Connection How would you describe your sense of belonging to the island ‘trans community’?

Community Connection How would you describe your sense of belonging to the mainland ‘trans community’?

Community Connection How would you describe your sense of belonging to the online ‘trans community’?

Community Connection How would you describe your sense of belonging to the international ‘trans community’?

Community Connection How important is having a strong ‘trans community’ to you?

Suicide 63% of participants had either considered or attempted suicide.

Suicide Transmasculine participants reported more occurrences

Suicide 31 to 50-year olds reported most occurrences

Priority Issues

Health Care Access Provincial, quick, affordable access to surgeries Local access to trans medical expertise Access to information about long-term use of hormones & trans-experienced providers Majority had primary care providers whom they trusted

Priority Issues Social Support Physical place for current, local information & resources Need to be able to provide support, not just receive Support group/Community/Hotline Social events (recreational) Web site with current information Social isolation characterizes experience (qual. study)

Priority Issues – Social Acceptance/Public Education – Mental Health Care Access Affordable individual therapy in timely manner Free or affordable access to therapists with trans expertise Group counselling – Legal Assistance Information on how to navigate bureaucracy in regard to name change, sex designation change

Next Steps Dissemination of findings to island health educators & service providers Pursuit of funding or partnership for centralized resource/information coordination Community building: Up to Us