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SOUTH ASIAN TRANS PEOPLE IN TORONTO: Issues Supports Rupert Raj, M.A., Counseling Psychology LGBT Counsellor Psychot

MENTAL HEALTH ISSUES. Low Self-EsteemDespairDepression AnxietyAngerSubstance UsePoor Body ImageEating Disorders. MENTAL HEALTH ISSUES (cont'd). Self HarmSuicidalityTrauma (emotional, physical, sexual, war)Psychiatric Conditions (Axis I/II)Social IsolationSocioeconomic Issues (poverty,

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SOUTH ASIAN TRANS PEOPLE IN TORONTO: Issues Supports Rupert Raj, M.A., Counseling Psychology LGBT Counsellor Psychot

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    1. SOUTH ASIAN TRANS PEOPLE IN TORONTO: Issues & Supports Rupert Raj, M.A., Counseling Psychology LGBT Counsellor (Psychotherapist)

    2. MENTAL HEALTH ISSUES Low Self-Esteem Despair Depression Anxiety Anger Substance Use Poor Body Image Eating Disorders

    3. MENTAL HEALTH ISSUES (contd) Self Harm Suicidality Trauma (emotional, physical, sexual, war) Psychiatric Conditions (Axis I/II) Social Isolation Socioeconomic Issues (poverty, housing) Family Problems Relationship Problems

    4. TRANS-SPECIFIC ISSUES Transphobia (discrimination, harassment, abuse, assault) Transqueerphobia (transqueers: lesbian/bisexual/pansexual transwomen & gay/bisexual/pansexual transmen) Genderqueerphobia (genderqueers: transcend normative gender binary)

    5. RACE-SPECIFIC ISSUES Multiplicity of Issues from Various Sectors: Racism (external/internalized) Transphobia (external/internalized) Homophobia (external/internalized) Familial Estrangement Religious Oppression Ethnoracial Stigmatization LGBT Community Discrimination Settlement Issues (immigrants/refugees)

    6. SHC TRANS-SPECIFIC ISSUES Gender Dysphoria (Gender Identity Disorder) Gender Identity Conflict Gender Identity Confusion Impoverished Self-Esteem Negative Body Image Transitioning Pre-Transitional Issues The Transitional Process Post-Transitional Issues

    7. SHC TRANS-SPECIFIC ISSUES (contd) Transitioning Identity Management Disclosure Management Medical, Counselling & Legal Resources Trans-Peer & Other Community Supports Electrolysis Treatments Hormone Replacement Therapy Sex-Reassignment Surgery Relationships re: Family, Friends, Partners, Co-Workers Job/Career Change

    8. SHC TRANS-SPECIFIC ISSUES (contd) Sexual Identity Potentially Trans Clients Confusing or Conflicting Sexual Identity with Gender Identity Trans-Identified Clients Exploring Sexual Identity Transqueer Identity Transpeople who identify as lesbian, gay, bisexual, transensual &/or polysexual, & who are out or in stealth

    9. SHC TRANS-SPECIFIC ISSUES (contd) Genderqueer Identity Fluid identification & presentation where gender identity intersects with sexual identity in a non-binary paradigm Multiple challenges experienced by these mostly young people: at home, at school, at work, in society & often in trans & queer communities, & when trying to access hormones & surgery

    10. COMMUNITY RESOURCES Alliance for South Asian AIDS Prevention hoping to start group for trans people Salaam men & transmen (suspended but still social events) women & trans women & trans men Asian Community AIDS Services Transgender Women Outreach Project 519 Church Street Community Centre trans peer-support groups

    11. CLINICAL RESOURCES Mental Health & HIV: David Kelley Services (Family Services Association of Toronto) Sherbourne Health Centre Sexual Health: Hassle-Free Clinic AIDS Service Organizations (ACAS, ASAAP, BLACKCAP)

    12. SHERBOURNE HEALTH CENTRE Community-based health care centre located in central southeast Toronto *opened in September 2002 Targets 3 primary client populations: Homeless/Underhoused People Newcomers (Immigrants/Refugees) LGBT Community (approx. 50%) (Trans Clients (approx. 9%))

    13. SHC EMPLOYEE REPRESENTATION Overall Staff Complement: 94 (68 F/T, 8 P/T, 18 casual/relief staff) LGBT Employees: not tracked but approx. 1/3 of overall staff 5 trans-identified staff 2 queer psychotherapists (incl. 1 trans) 5 queer physicians 3 queer nurses People of Colour/South Asian Employees: not tracked for overall staff 3 South Asian psychotherapists 3 other P.O.C. psychotherapists 1 South Asian (gay) physician 1 P.O.C. LGBT physician

    14. SHC TRANS & NEWCOMER CLIENTS LGBT Clients = approx. 50% Trans People = approx. 8% (380-465 out of 6291) Newcomers = 8.4% (526 out of 6291) People of Colour = % unknown People Living with HIV+ = % unknown

    15. SHC TRANS CLIENTS Demographic Profile Transsexual, Transgender, Genderqueer, 2-Spirit, Intersexed Age Range: 14-66+ years People of Colour (? South Asian) Immigrants/Refugees Sex Workers Physical/Emotional Disabilities Poor/Low Income Homeless/Underhoused Trauma Survivors

    16. SHC TREATMENT APPROACH Interdisciplinary Collaborative Care Model Client-Centred Collaborative Relationship Informed Consent Interdisciplinary Teams Anti-Oppression Framework Trauma Framework

    17. SHC PROGRAMS & SERVICES General Primary Health Care General Mental Health/Counselling Services Comprehensive Primary Health Care for Lesbian, Gay, Bisexual, Transgender and Transsexual Communities Supporting Our Youth (LGBT-specific) Mobile Health Care (Health Bus) Infirmary Community Chiropractic Clinic Community Naturopathic Clinic for People Living with HIV/AIDS

    18. SHC TRANS-INCLUSIVE & TRANS-SPECIFIC SERVICES Primary Health Care General Physical Health Sexual Health Hormonal Therapy Assessment (medical history, bloodwork, referral re: consultation with counsellor &/or psychiatric assessment, as indicated) Prescription Administration (injections for transmen/FTMs) Monitoring/Follow-Up

    19. SHC TRANS-INCLUSIVE SERVICES (contd) Mental Health Care Individual Counselling Couple Counselling Family Therapy Group Work Walk-in-Therapy Clinic On-Site Psychiatric Consultation

    20. TRANS-INCLUSIVE & TRANS- SPECIFIC SERVICES (contd) Groups Outside the Lines (expressive arts group for isolated lesbians, bi & trans women) Mens/Womens Communications Group (respectively) Gender Journeys (psychoeducational group for people considering transitioning to other gender) Transceptance (community-based, peer-support group for parents of trans children)

    21. SHC TRANS-INCLUSIVE & TRANS-SPECIFIC SERVICES (contd) Workshops Trans Health Project Towards A Transpositive Therapeutic Model For Parents & Family Members of Transpeople Releasing Rage through Boxing Hormone Therapy for Transpeople For Transpeople of Colour & Two-Spirit Peoples For Transpeople & their Partners Special Events Annual Trans Pride Day Queer Health Matters (annual fair) South Asian Heritage Day

    22. SHC TRANS-SPECIFIC SERVICES Information/Consultation Consultation for clients/patients & providers Community Health Initiatives Health promotion, prevention & education Research projects (SHC Infirmary & OPHA Trans Health Project focus groups, respectively) Research page included on our webpage: www.sherbourne.on.ca

    23. SHC TRANS-SPECIFIC SERVICES (contd) Community Partnerships Trans Pulse Project (community-based research project) Rainbow Health Network Trans Health Lobby Group Advocacy Letter advocating Ontario Ministry of Health to re-enlist sex-reassignment surgery, etc.

    24. HOW TO CONTACT US Mailing Address Sherbourne Health Centre 333 Sherbourne Street Toronto, Ontario M5A 2S5 Phone Number: (416) 324-4180 Fax Number: (416) 324-4181 Website: www.sherbourne.on.ca Rupert Rajs E-Mail: rraj@sherbourne.on.ca

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