Vancouver IslandTransgender Needs Assessment

matthew heinz, phdRoyal 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.

• 62.90% 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 OrientationThe majority (59.20%) selected more than one label to

describe their sexual orientation.

Total TransFem TransMasc

Queer 40.70% 12.95% 27.75%

Straight 24.05% 7.40% 16.65%

Lesbian 22.20% 18.50% 3.70%

Not Sure 22.20% 7.40% 14.80%

Bisexual 20.35% 14.80% 5.55%

Pansexual 18.50% 9.25% 9.25%

Gay 14.80% 3.70% 11.10%

Two-Spirit 12.96% 7.40% 5.55%

Asexual 1.85% 0 1.85%

EducationMajority (70.30%) have graduated from a college or trade school, studied at university, or graduated from

university with bachelor’s or graduate degrees.

Not High School Grad

High School Grad

Some college/trade school

College/Trade Graduate

Some university

Univ Grad (UG)

Univ Grad (Grad)

0 2 4 6 8 10 12 14

TransMascTransFemTotal

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?

Yes, Positively

Unsure

Yes,Negatively

No

0 5 10 15 20 25

Sex WorkThe majority reported not ever having done sex work or

exchanged sex for money or other resources .

7%

93%

Sex WorkNo Sex Work

Health

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

46%

54%No Health IssueOther Health Issue

Health Issues

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

Mental Health Condition

Chronic Illness

MobilityDisability

Learning Disability

Vision/Hearing

Autism

0 2 4 6 8 10 12 14

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.

Very Satisfied

Somewhat Satisfied

Neither

Dissatisfied

Very Dissatisfied

Don't Know

0 5 10 15 20 25 30

TransMascTransFemTotal

Attitudes Toward Self

• On the whole, I am satisfied with myself. Agree/Strongly Agree 87%• I have a number of good qualities. Agree/Strongly Agree 96%• I am able to do things as well as othersAgree/Strongly Agree 87%• I’m a person of worth equal to others. Agree/Strongly Agree 92%• I take a positive attitude toward self Agree/Strongly Agree 76%• • At times I think I’m no good at all. Disagree/Strongly Disagree 63%• I don’t have much to be proud of. Disagree/Strongly Disagree 76%• I wish I could respect myself more. Agree/Strongly Agree 67%• I certainly feel useless at times Agree/Strongly Agree 56%• All in all, I feel I’m a failure. Disagree/Strongly Disagree 80%

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.

• 46.25% have experienced verbal harassment.• 77.70% 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.

A lot better

Somewhat better

Stayed the same

Somewhat worse

A lot worse

No answer

0 2 4 6 8 10 12 14 16 18

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%).

Increased a lot

Increased somewhat

Stayed the same

Decreased somewhat

Decreased a lot

0 2 4 6 8 10 12 14 16 18

Total

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).

Extremely Stressful

Quite a bit Stressful

A bit Stressful

Not very stressful

Not at all stressful

Don't Know

0 2 4 6 8 101214161820

TransMaleTransFemTotal

Social Isolation

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

All of the time

Most of the time

Some of the time

A little of the time

None of the time

0 5 10 15 20 25

Total

Total

Social Isolation

Participants often hear that they are not normal.

Never

Once/Twice

Sometimes

Many times

No answer

0 5 10 15 20 25 30 35

How often have you heard that trans people are not normal?

Total

Community ConnectionHow would you describe your sense of belonging to

the island ‘trans community’?

Very Strong

Somewhat Strong

Somewhat Weak

Very Weak

0 5 10 15 20 25 30

Total

Community ConnectionHow would you describe your sense of belonging to

the mainland ‘trans community’?

Very Strong

Somewhat Strong

Somewhat Weak

Very Weak

0 5 10 15 20 25 30 35 40

Total

Community ConnectionHow would you describe your sense of belonging to

the online ‘trans community’?

Very Strong

Somewhat Strong

Somewhat Weak

Very Weak

0 5 10 15 20 25 30

Total

Community ConnectionHow would you describe your sense of belonging to

the international ‘trans community’?

Very Strong

Somewhat Strong

Somewhat Weak

Very Weak

0 5 10 15 20 25 30 35 40

Total

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

Very Important

Somewhat Important

Neutral

Not Too Important

Not Important At All

0 5 10 15 20 25 30

Suicide63% of participants had either considered or attempted suicide.

35%

28%

37%Considered SuicideAttemptedNot Considered

Suicide

Transmasculine participants reported more occurrences

ConsideredAttempted

0

5

10

15

20

25

30

35

TotalTransMascTransFem

Suicide

31 to 50-year olds reported most occurrences

ConsideredAttempted

0

5

10

15

20

25

30

35

Total18-30 years31 to 5051+

Priority Issues

24%

24%19%

12%

7%

7%7%

Self-Identified Priority Need

Health CareSocial SupportPublic AcceptanceMental HealthLegal IssuesEmploymentOther

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