COGS 1st International Meeting (2020): Talks

Sexual Health Equity

Kate Shannon (Centre for Gender and Sexual Equity / UBC)
January 8, 2020

Great, so thank you and good afternoon. I first want to really start off by giving a huge kudos to Jill, as well as Cara, in terms of this great meeting today. I sat on the institute of Gender and Health advisory board for 6 or so years, with Jill when she was chairing it, and with Cara during her early days of a scientific director, and with Joy previously, and it’s wonderful to see this coming together, and coming to fruition from the early ideas. It’s wonderful to see this coming together and I think it’s huge kudos to you in just bringing this amazing day together, and I know it’s been many years in the making but it just speaks to, as Cara just presented, really a decade of work and more in sex and gender science.

I just want to also acknowledge that we’re gathered here today on the unceded territories of the Masquian Squamish, as well as two nations, and this is an incredible mural that was just recently painted in the centre of gender and sexual health equity new office space in the Downtown East Side, by an indigenous women’s art collective, and specifically by an artist Hasla Collins, as part of our commitment to cultural safety humility within the centre, and is meant to really speak to strength and resilience of indigenous and non-binary people.

Moving into today, I’m asked to do a really lightning talk, so I’ll just be speaking really briefly about some examples around sexual health equity. There’s a range of definitions that are out there in terms of what sexual health is, but there is an increasing recognitions from really moving away from a deficit based focus on sexual health, which has largely been around STI’s in particular, to a more encompassing sexual health definition, and really considering issues with equity.

So, sexual health broadly includes freedom from gender-based violence, issues around sexual expression and gender identity inclusion, sexual consent as well as pleasure and rights, and within the broader comprehensive sexual health, education, reproductive justice access, as well as prevention and care of sexual health.

So, really building on some of what Cara spoke about today, I really want to challenge us- while drawing on our work, as well as many others- is the need to really think around complexity and intersectional approaches, and how we look at sex and gender science. And I think it was really great to see the last 10 years of where we’ve been and some of the big advancements, but also some of the unintended consequences, which has really led to some binary discussions, and often where people think they’re making incredible pronouncements of “we can see the difference in here between these two things”, it’s very cis-normative, very heteronormative, and really focused on a really binary approach. And I think there’s some great images out there, but how we reach things like gender equality is really though a lens of equity. And equity really necessitates those intersectionality’s approach.

So, I’m going to speak really briefly on some of the work that we’ve done and where some of that work has looked.

This is actually a project led by Jill Shetiar with our group, trans health research project, but really in the centre of the focus is who’s missing, and what’re the discussions that are not there, and then that opens space for where we can go in terms of shifting some of the discussions.

So how do we move past from what’s been really great advancements, and how do we move towards the next era of sex and gender science, that really does look at intersectional approaches.

One area in terms of gender-based violence, historically, but even in many times today within the public discussions and media, gender-based violence is really narrowly focused around intimate focused violence within heterosexual relationships. So, it’s really focused on intimate partner violence experience by women, and we have much less data around gender-based violence within the broader context.

This is the current definition that’s used by Canada, so you can see a much broader definition that’s really focused on violence, but it’s perpetuated against someone based on their gender, gender expression, gender identity, or their perceived gender.

And yet, most of the work and documents will really focus on, and most of the research that’s available, our large-scale research, is really around violence against women specifically within intimate partner violence, and what are those health impacts, what are those mental health, sexual and reproductive health impacts.

So, we really know much less about gender-based violence within the broader context, despite the fact that both within Canada, and globally within LGBTQ communities, and many other communities, are really disproportionately represented in terms of experiences of gender-based violence.

Within the Canadian context, and some of where our work’s increasingly centering, there was a large-scale investigation, that looked at access to sexual assault for people who’d experienced sexual violence. And what this large-scale investigation found was across Canada, was really high rates of people reporting violence to police, and it being considered unfounded. So not considered essentially triage out of this justice system.

And what a lot of research from many research and community experts has shown, is that really, many of the same factors that are putting people in a disproportionately experiencing gender based violence, and sexual based violence in particular, are the same factors that are increasing various to accessing justice, or accessing health services and supports. And those really do intersect along gender, race, class.

And so, some of our work, and increasingly with our new grant, is really focused on looking at what are those various access and justice, and who are those populations, who are really underdiscussed within the context of gender-based violence.

So we recently have received some funds working with the Western Aboriginal [inaudible] society, sex workers united against violence, and [inaudible] resources society, to really look at what are gender based violence experiences in more marginalized women, and non-binary people within the Vancouver context, as well as the neighboring communities.

And I think part of where some of the discussions are over the next few days are “how can we bring this intersectional lens across a lot of the work”

This is another example of where I think intersectional approaches are critical. This is work done by a graduate student at the time, that was really looking at housing, and how housing as a structural force, was really creating violence for many marginalized communities in the downtown eastside. And so, these quotes of people living within the single-room occupancy hotels and shelters in the downtown eastside and talking about housing can create itself as a structural form of violence.

So, one other area that I’ll speak about, and a lot of my work has centered over the last decade, has really been around the role of sex work laws and the Canadian work laws, as well as the local sex work laws. The shirts say, “not criminals, not victims”, and these were new laws that were put in place in 2015, following a supreme course case, and they were put in place by the conservative government at the time, following the supreme court case. They really blatantly disregard a lot of the science in this area.

And so over the last 10 years, we’ve been evaluating the impact of these laws, and this is a report that was released in December, that really looked at “what are the harms of Canada sex work laws, and how are those perpetuating health and safety risks to sex workers”.

So, one of the key pieces that we see is that the same laws are really replicating many of the same barriers to sex workers. And I think in terms of when we think about gender relations, gender negotiations, a lot of the critique has been a lot of laws of a very gendered mind. And in this case, quoted “the ends have essentially harassing clients to save us harassing the women or workers”.

And so essentially, one part of this in Canada is that clients are criminalized in Canada, whereas sex workers are not. So, what that means is that sexual consent, and the exchange, and around everything that is required around consensual sexual relationships is not possible in the Canadian context. And I think this just goes to show how little in the context of policy makers, and how important it is as researchers to get some of that evidence to policy makers of “what does consent look like and how can you create laws for a current government who’s very much pro-gender equity, and issues in consent”, we’re hoping to see some changes, but as of yet there hasn’t been any shifts in this area.

Another part of this report and this is work being led by a current PhD student, Robin McBride, is really looking at third parties, and debunking some of the myths of what we think of third parties as exploitative pimps. And a lot of that actually, or that most of the people think about, is cis-gender men as the largely, the primary third parties. And in this case, the majority of managers or third parties we spoke with were in fact cis-gender women and former sex workers themselves. And so, the quotes from people who were “I know my boss has my back no matter what”. And so, some of that is how can our research shed light on what is much more complex in terms of what these relationships look like, and what work context looks like for sex workers.

So, I just want to end on one other piece which is the work being led by Tara Lion’s and group, which was really looking at for trans sex workers and non-binary workers, how negotiating transphobia, within a context of a broader concept of structural violence, and how really going back to the role of intersectionality, how in these contexts, these really these graphic discussions about how negotiation around gender was paramount to many of the safety mechanisms in terms of being able to put in place, particularly in a criminalized context.

On a more good news front, within the global context, there has been an increasing recognition of the need for more evidence-based policy around sex work, alongside other evidence-based policy-based discussions on sexual and reproductive health. And this is amnesty international’s report that was released last year, that came squarely calling for decriminalization for sex work, but also included other key pieces around sexual and reproductive health.

So, I wanted to use those as brief examples, of why, building off of what Cara was speaking to, how critical it is to have a more complex discussion of gender and sex, and intersectional approaches, but move beyond that binary approach. We’ve made some really great advancements, but I think with this new decade, we have a chance and an opportunity to really push those boundaries of sex and gender science, and also talk about what are gender transformative, so along that spectrum, we want to be one of those gender transformative equity based approaches. So, making sure that what we’re doing in terms of research, is translating and reaching policy and practice.

Supporting Organizations

Women's Brain Health Initiative logo and website link Women's Health Research Cluster logo and website link Ontario Brain Institute logo and website link Women's Health Research Institute at BC Women's logo and website link Libin Cardiovascular Institute of Alberta logo and website link Canadian Institutes of Health Research logo and website link Women and Children's Health Research Institute logo and website link Elsevier logo and website link Centre for Gender and Sexual Health Equity logo and website Linköping University logo and website link Heart Stroke logo and website link centreDeRecherche logo and website link UMontreal logo and website link Einstein lab logo and website link