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Publications from our network

Publications listed below feature authors or team-members from the 2S/LGBTQ+ Health Hub network. This collection features a range of publication types - enjoy your read! 

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Publication 10/4/2021

Toward an inclusive digital health system for sexual and gender minorities in Canada

Community-Based Research   Mixed-Methods   Digital Health/Technology   Health Equity   Health Services   2S/LGBTQ+   Gender Diverse   Trans   National

Most digital health systems record gender and sex as a single binary field, which discourages sexual and gender minority people from seeking preventative screening and gender-affirming care. Over a one-year multi-method project, participants co-created an action plan to modernize how gender, sex and sexual orientation information is handled in Canadian systems. Seven actions are proposed: envisage an equity-oriented health system; engage communities and organizations; establish inclusive terminology; enable systems to collect, use, exchange and reuse standardized data; integrate that data collection within organizations; educate staff to deliver culturally competent care and explain to patients why the data matters; and create a central coordinating hub.

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Publication 8/25/2021

Public health morality, sex, and COVID-19: sexual minority men's HIV pre-exposure prophylaxis (PrEP) decision-making during Ontario's first COVID-19 lockdown

Cornel Grey, Western University

Alex Wells, University of Victoria

Darrell Tan, Unity Health Toronto

Critical Public Health

Community-Based Research   Intersectional Approaches   Qualitative   Policy   PrEP   Sexual Health   STBBIs   2S/LGBTQ+   Bisexual   Gay   GBMSM   Queer   Regional

During Ontario's first COVID-19 lockdown, HIV-negative gay, bisexual, and queer men had to weigh pandemic rules against their sexual lives and PrEP routines. Drawing on in-depth interviews with 25 such men and a thematic analysis informed by the sociology of risk, this study traces a public health morality, a contested sense of what counts as responsible sexual citizenship. Shaping it were self-concern versus risk to others, anxiety and economic precarity, pandemic weariness, shaming of non-compliance, and echoes of HIV-era stigma toward queer sex. Men altered practices, stopping, restarting, or stockpiling PrEP, while reviving negotiated safety strategies from HIV prevention.

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Publication 8/16/2021

Who Counts as Trans? A Critical Discourse Analysis of Trans Tumblr Posts

Critical Theory   Qualitative   Digital Health/Technology   Stigma   2S/LGBTQ+   Trans   Youth

Online spaces let trans communities build knowledge together, and also draw lines around who belongs. This study uses critical discourse analysis of Tumblr posts to examine how trans users define who counts as trans, including how they understand gender dysphoria and its relationship to trans identity. Tumblr has become a popular gathering place for trans youth, and these debates run parallel to shifting medical and mainstream understandings of being transgender. While such platforms can support positive identity formation, the analysis shows communities may reinforce dominant narratives as well as disrupt them, amid an ongoing struggle for visibility, resources, and respect.

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Publication 8/1/2021

"We're all in an abusive relationship with the health-care system": Collective memories of transgender health care

Community-Based Research   Qualitative   Trauma/Violence Informed   Health Equity   Health Services   Stigma   2S/LGBTQ+   Trans

Collective memory work invites people to recall and analyze their own experiences together, linking personal stories to shared patterns. Six trans participants used this method during a four-hour focus group, examining their health care memories and reaching collective agreements about what those stories meant. The analysis describes a relationship with the health care system that participants characterized as toxic, even abusive. They described asking tentatively for services, unsure whether care would be provided, what its quality would be, or whether they would be treated with respect. Even positive encounters were framed mainly as fears not realized, and all involved some inappropriate conduct.

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Publication 2/25/2021

'I was just doing what a normal gay man would do, right?': The biopolitics of substance use and the mental health of sexual minority men

Zack Marshall, University of Calgary, McGill University

David J Brennan, University of Toronto

Joseph Cox, McGill University

Trevor Hart, Toronto Metropolitan University

Daniel Grace, University of Toronto

Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine

Community-Based Research   Intersectional Approaches   Qualitative   Mental health   Substance Use   2S/LGBTQ+   Men   Bisexual   Gay   Queer   Urban

How do gay, bisexual and queer men understand the link between their drug and alcohol use and their mental health? Twenty-four interviews with GBM in Toronto reveal deep ambivalence. Participants described substances as therapeutic aids that eased distress, and also as corrosive to wellbeing, drawing a fine line between use that felt self-productive and use that felt self-destructive. Some framed their choices as problematic or unhealthy; others presented themselves as controlled, responsible actors simply doing what a normal gay man would do. The authors connect this ambivalence to polarizing community and scientific binaries around addiction, control and rationality.

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