Experiences of Trans Women and Two-Spirit Persons Accessing Women-Specific Health and Housing Services in a Downtown Neighborhood of Vancouver, Canada

Abstract

Purpose: Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Methods: Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Results: Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Conclusion: Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth.

Transgender Women with Severe Mental Illness and Homelessness: A Retrospective Case Series

“…Only one of the three patients included in our study was housed in a gender-segregated shelter (the other two were in a situation of rooflessness). A recent study shows that exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence [11]. And in this sense, all our patients had been victims of crimes while they were in a situation of homelessness.…”

“…The discrimination and stigma that TW with SMI encounter shape HIV vulnerability. For example, condomless sex has been found to be associated with unstable housing and experiences of transphobia among TW [11]. The potential costs of excluding TW from health and housing services include increased HIV vulnerability through reduced access to HIV prevention services, and through homelessness and social exclusion that are structural risk factors for HIV [11] [12].…”

Acesso de travestis e mulheres transexuais a serviços de Atenção Primária à Saúde: revisão integrativa de literatura

“…Entretanto, estamos longe de ter uma saúde ou um atendimento com qualidade integral, universal e equânime para a população LGBT em geral , como visto nos estudos que abordam as dificuldades vivenciadas e experimentadas pelas pessoas transgênero, gays, Research, Society and Development, v. 9, n. 10, e2149108595, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i10.8595 10 lésbicas, bissexuais para serem assistidos com humanização, acolhimento e resolutividade para seus problemas de saúde em geral e processos transexualizadores (Popadiuk, Oliveira & Signorelli, 2007;Sousa et al, 2009;Alencar Albuquerque et al, 2016;Lyons et al, 2016;Rocon et al, 2016;White Hughto et al, 2016;Johns et al, 2017;Marcela-Dominguez et al, 2018).…”

“…Assim como Lyons et al (2016), em estudo realizado com mulheres transexuais no Canadá, apontam para a "passabilidade", entendida como a "capacidade de atribuírem à imagem da travesti ou da mulher transexual uma aproximação à imagem de uma mulher cisgênero" enquanto fator de proteção e aceitação nos serviços de saúde.…”

“…Capozzolo et al (2004) enfatizam que o acesso deve ser garantido não só para aqueles que procuram, mas também para aqueles que mais precisam, a partir da organização dos serviços de atenção à saúde e identificação das prioridades tendo como base o perfil epidemiológico do território e a otimização dos recursos existentes entre os usuários e os serviços de saúde.Portanto, constata-se que houve dificuldades vividas e experienciadas pelos usuários com diferentes orientações sexuais para acessar o sistema de saúde de diferentes países(Brasil, Canadá, Estados Unidos e Colômbia) e ter assegurado o seu direito de atendimento às necessidades de saúde (AlencarAlbuquerque, 2016;Lyons, 2016;Rocon et al, 2016; …”