Research

  • Toward a Practice Framework for Sexual and Gender Minority Forced Migrants Acculturating into Canadian Society

    Through individual interviews, this study aims to achieve two objectives. The first objective of this study is to illuminate how LGBTQ-affirmative mental health care providers and refugee mental health providers describe their readiness to support LGBTQ forced migrants in Canada. The second objective is to learn what therapeutic approaches best support LGBTQ forced migrants’ mental health and wellbeing. The specific aims of the study are to a) identify gaps in knowledge, attitudes, and skills in serving LGBTQ refugees/forced migrants; b) uncover emerging best practices for serving LGBTQ refugees/forced migrants that can be shared with a diverse array of mental health practitioners; and c) understand from LGBTQ refugees/forced migrants who have received treatment from mental health providers what factors facilitated and/or hindered their mental health and wellbeing. These objectives and aims will be achieved through triangulating the insights, expertise, and experiences with four subsample groups: 1) LGBTQ-affirmative mental health providers with no experience serving refugees; 2) refugee mental health providers with no experience serving LGBTQ individuals; 3) mental health providers who have experience serving LGBTQ refugees/forced migrants; and 4) LGBTQ forced migrants themselves who have received treatment from mental health providers. Samples will be recruited across Canada.

  • Exploring the State of Sexual Health Literacy among Young Black Men Who Have Sex with Other Men in Toronto

    Despite advancements in diagnosis, prevention and treatment of HIV and other STIs, young straight and gay, bisexual, queer + men (GBQ+) continue to be at heightened risk of infection in Canada. In 2010, individuals aged 15-24 years made up 62.8% of all positive chlamydia and 48.7% of gonorrhea reports (Public Health Agency of Canada, 2014). In the same year, young men made up 90.5% of all infectious syphilis cases(PHAC, 2014). HIV infection risk is very high for certain subpopulations of young Canadians. National HIV surveillance data from 2014 found 65% of new youth HIV diagnoses were among GBQ+ while 19% were linked to heterosexual sex (Challacombe, 2017). Although national HIV rates based on populations’ age, race and sexual orientation could not be found, Toronto based HIV surveillance data showed positive HIV diagnoses among Black GBQ+ rose from 11.5% between 2009-2011 to 18.9% in 2012 (p=0.008) while their White counterparts’ rates fell from 61.4% in 2009-2011 to 52.4% in 2012 (p=0.02) (Laboratory Enhancement Program, 2013). An international study that reviewed factors linked to HIV disparities among Black GBQ+ populations in Canada, the U.S. and U.K. found young Black GBQ+ were five times more likely to be HIV-positive than other young GBQ+. They also had a 45% higher chance of testing positive for other STIs (Millett, Peterson, et al., 2012). While the literature shows various social (e.g. racism) and structural (e.g. low income) factors contribute to the aforesaid risks by impacting sexual healthcare access or prompting sexual risk practices (e.g. condomless sex) (Maulsby et al., 2014), it also indicates young Black GBQ+ have safe sex. One study showed Black and White men were equally likely to get HIV testing and see healthcare providers (Maulsby et al., 2014) implying Black men have some sexual health literacy—people’s ability to understand, make sense of and use sexual health information in their daily lives. While there is a lot of research on the impact on the earlier mentioned factors on young Black GBQ+ sexual health, there continues to be a gap in research on this perplexing contradiction between these youths’ high STI rates and their sexual health literacy. As STI rates among young GBQ+ keep rising, more research focused on these youths’ sexual health literacy is needed. The research goals are to: 1) Identify sources of young Black GBQ+ men’s sexual health information; 2) Identify how young Black GBQ+ men evaluate the information they get from these sources; and 3) identify the ways, if any, these young men are applying this information to their everyday lives Anticipated Outcomes: This study is one step towards identifying: 1) Gaps in current sexual healthcare services and resources; 2) How Black GBQ+ men youth locate, evaluate and use sexual health information; and 3) Ways to enhance youths’ sexual health literacy. References Challacombe, L. (2017). The Epidemiology of HIV in Youth. Retrieved from http://www.catie.ca/en/factsheets/epidemiology/epidemiology-hiv-youth#footnote7_2ab1uey Laboratory Enhancement Program. (2013). Laboratory Enhancement Program HIV Laboratory, Public Health Ontario Updated analyses: January 2009 to December 2012. Retrieved from http://www.ohemu.utoronto.ca/doc/2013/LEP%20ethnicity_2009-2012.pdf Maulsby, C., Millett, G., Lindsey, K., Kelley, R., Johnson, K., Montoya, D., & Holtgrave, D. (2014). HIV among black men who have sex with men (MSM) in the United States: A review of the literature. AIDS and Behavior, 18(1), 10-25 Millett, G. A., Peterson, J. L., Flores, S. A., Hart, T. A., Jeffries, W. L., Wilson, P. A., . . . Fenton, K. A. (2012). Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: A meta-analysis. The Lancet, 380(9839), 341-348. Public Health Agency of Canada. (2014). Population-Specific Status Report-HIV/AIDS and other sexually transmitted and blood borne infections among youth in Canada

  • Canadian Trans Youth Health Survey 2018

    Many studies address lesbian, gay, bisexual, transgender, and queer (LGBTQ) health outcomes, however it is common for these studies to overlook the "T,” or transgender, portion of this population. In light of this, the Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC) conducted the first-ever Canadian Trans Youth Health Survey in 2013/14 – a national, online survey focused on the health of trans and non-binary youth in Canada. Findings suggested that transgender and non-binary youth are particularly vulnerable to sexual harassment, violence, mental health issues, and other health challenges. The objective of this study is to develop an understanding of trans and non-binary youth’s physical and emotional health, as well as risks to their health and well-being. This study will help us understand how (and if) various health outcomes for trans youth differ from their heteronormative, gender-normative, and gay, lesbian and bisexual peers’ health outcomes. Results will also help show how the home, community, and school environments can contribute to health issues or wellness for trans and non-binary youth. Data from this survey will also be used to measure changes (if any) over the past 5 years since the first survey was conducted. The results will provide information that will help to improve health services, health policies and raise awareness of the health needs of trans and non-binary youth.

  • Understanding the Long-Term Health Effects of Family Rejection on Queer and Transgender Women

    The objective of this research is to better understand the long-term impact of identity-based family rejection on the lives of queer and transgender women, and the ways family rejection impacts the life course trajectories of queer and transgender women. Family rejection as a result of sexual and/or gender identity, and/or gender expression is a risk factor unique to queer (non-heterosexual) and transgender[1] women, compared to their heterosexual and cisgender counterparts. The immediate and short-term effects of identity-based family rejection on queer and transgender women are well established; this type of rejection can cause exacerbated levels of depression and suicidality increased substance use, lower levels of life satisfaction, increased sexual risk behaviours, legal problems, and is a leading cause of homelessness among queer and transgender youth. For some queer and transgender women, family rejection experiences can be severe, including verbal and/or physical assault from family members based on sexual and/or gender identity. The U.S. National Transgender Discrimination Survey (n=6456) found that transgender women were more likely to experience a higher severity of family rejection compared to transgender men, putting them at a higher risk for detrimental health outcomes. The negative effects associated with identity-based family rejection may be caused by several reasons: family rejection itself is a stressor that can have direct negative impacts on mental health, economic security, and attendant health behaviours. It can also deprive queer and transgender women from the positive buffering effects of familial and close social support. Despite having knowledge of the short-term effects of identity-based family rejection on queer and transgender women, as well as the potential mediating pathways, we are only aware of one study that has examined the association between identity-based family rejection and health outcomes in adulthood for sexual minority women, which was based in Vietnam and none regarding transgender women. To address this gap, we propose to explore the long-term effects of identity-based family rejection on queer and transgender women. 1. Examine the health trajectories of queer and transgender women who have experienced family rejection as a result of their sexual and/or gender identity, and/or gender expression. 2. Document the perspectives of queer and transgender women who have experienced family rejection as a result of their sexual and/or gender identity, and/or gender expression, regarding the relationship between their health trajectories and their experiences of rejection. The main research questions include: 1. What are the long-term mental and physical health effects of identity-based family rejection on queer and transgender women? 2. How do experiences of identity-based family rejection shape the life course trajectories of queer and transgender women?

  • Facilitators of and Barriers to Accessing Reproductive Care in Canada for Same-Sex Male Couples and Single Men

    Increasingly in Canada, same-sex male couples (SSMC) and single men (SM) are using assisted reproductive technologies (ART) such as egg donation, in-vitro fertilization and surrogacy, in order to have children. For men in particular, there are significant considerations involved when undergoing the process of third-party reproduction via ART. For example, intended parent(s) must decide upon who will be the egg donor and surrogate, choose which partner will have a genetic link to the child if in a relationship, choose when and where to receive ART, decide upon a healthcare provider and legal advisers, as well as reconcile how personal lives and social networks might change upon having a child(ren). These considerations are in addition to the substantial amount of time, effort, and financial resources required when using ART. Despite an increase in the use of reproductive care by this specific demographic, the research on men's experience of accessing ART in Canada is lacking. Reproductive healthcare services have yet to optimize the clinical care model for SSMC and SM wanting to start their families. Therefore, it is paramount that research is done to understand the experience of men accessing reproductive care in a Canadian context. Through this study, I hope to explore the psycho-social aspects related to same-sex male couples and single men who are currently using, or have previously used, ART in Canada to have children. The objectives of the study include: (1) to understand how men perceive the experience of using ART, and determine what proportion of men have a positive experience; (2) to determine what factors influence the overall experience of men using ART; and (3) to understand what influences decisions made throughout the ART process. The research plan for this study is to conduct an anonymous, online survey, in order to assess men's experiences of using ART in Canada.

  • Development and Validation of Sexual Quality of Life Questionnaire for Men-Who-Have-Sex-with-Men with Prostate Cancer

    The purpose of this study is to develop a sexual function survey specific for men who have sex with men (MSM) and others with prostates, and who have also been diagnosed with prostate cancer. This survey will be used to further research on MSM and other people with prostates who have prostate cancer, and help such men make treatment decisions. Our goal is to reach 200 participants for this phase before we analyze results for producing a more refined assessment tool for the final phase of our study.

  • PEERS: Peers Examining Experiences in Research Study

    There is a movement towards increased community engagement and participation in research. Both funders of research and communities recommend meaningful engagement of communities under study throughout the research process. One mechanism of engagement is the inclusion of peer researchers. Peer researchers are researchers whose lived experience with a subject being studied is a requirement of their employment with a research project. Peer researchers may enhance the research through their lived experience. The engagement of peer researchers is also intended to benefit both the peers and the communities to which they belong. However, despite being widely recommended, there has been very little research on the process, context, and outcomes of peer researcher engagement. Peers Examining Experiences in Research Study (PEERS) is a qualitative, community-based project that aims to address this question. PEERS is a team of academic, community-based, and peer researchers who are examining how peer researchers experience their involvement in research with four communities: • lesbian, gay, bisexual, trans, queer and two-spirit (LGBTQ2S+) communities • racialized communities • communities of people who use drugs • consumer/survivor/mad/mental health service user communities The objectives of this research are to: a) examine how peer researchers experience involvement in the context of participatory research. b) determine how peer researchers experience benefit and/or harms from their involvement in participatory research. c) Identify similarities and differences in experiences of inclusion, benefit, and harm between four communities whose members are commonly engaged as peer researchers: LGBTQ2S+ communities; racialized communities; communities of people who use drugs; and consumer/survivor/mad/mental health service user communities. d) identify and disseminate research practices that attend to important differences between communities to best achieve the emancipatory aims of participatory methods. We will use our findings to make recommendations for participatory research in general, as well as research with these four communities specifically, to maximize the meaningful involvement of peer researchers.

  • Does current hormone therapy maintain bone health in transgender individuals after gonadectomy?

    In transgender medicine, we are completely reversing sex hormone levels. Sex hormones play a major role in regulating bone health. In order to ensure that the bone health of transgender individuals is not being harmed in the long term, we must ensure that the service we are providing is able to maintain bone health. In particular, there is evidence that transgender individuals are at risk of bone loss following gender affirming surgery where the ovaries or testes are removed. This study aims to determine whether current hormone regimens given to transgender patients after gender affirming surgery are sufficient for maintaining bone density. We will prospectively examine the bone health before and one to three years after gender affirming surgery in a cohort of transgender patients. Methods to examine bone health will include bone turnover markers, and bone mineral density exam. Changes in bone density and bone markers will be correlated to their hormonal regimen and hormone levels. This will provide insight as to whether current hormone regimens need to be revised in order to optimize bone health in transgender individuals. Research participants will have two study visits; the first visit will be before their surgery, and the second visit, at least 1 year after their surgery. Both study visits will involve a bone density test (like an x-ray), a questionnaire and possibly some blood tests.

  • Engage: Advancing Gay and Bisexual Men’s Sexual Health

    Engage is a 5-year Canadian collaboration between researchers and community-based organizations on HIV and sexual health among gay, bisexual, and queer men, including trans men and other men who have sex with men (gbMSM) in Canada. Its three primary aims are to provide research evidence to inform HIV and STBBI prevention initiatives for Canadian gbMSM, build capacity for a pan-Canadian network on HIV and sexual health research for gbMSM, and integrate community engagement into all stages of the project to enhance community-researcher collaboration and bidirectional knowledge exchange.