Barriers to well-being for Aboriginal gender-diverse people: results from the Trans PULSE Project in Ontario, Canada

Purpose – Despite health inequities experienced by Aboriginal and transgender (trans) communities, little research has explored the well-being of Aboriginal trans (gender-diverse) people. This paper aims to describe barriers to well-being in a sample of Aboriginal gender-diverse people in Ontario, Canada. Design/methodology/approach – In 2009-2010, 433 trans people in Canada's most populous province participated in a multi-mode health survey. In all, 32 participants identified as First Nations, Métis, or Inuit (Aboriginal); unweighted frequencies were calculated to describe their characteristics. Findings – Participants expressed diverse gender identities; 44 per cent identified with the pan-Aboriginal term two-spirit. High levels of poverty (47 per cent), homelessness or underhousing (34 per cent), and ever having to move due to being trans (67 per cent) were reported. In all, 61 per cent reported at least one past-year unmet health care need. Most participants had experienced violence due to being trans (73 per cent) and had ever seriously considered suicide (76 per cent). One-fifth had been incarcerated while presenting in their felt gender. Aboriginal spirituality was practiced by 44 per cent, and 19 per cent had seen an Aboriginal Elder for mental health support. Research limitations/implications – Action is needed to address the social determinants of health among Aboriginal gender-diverse people. Using principles of self-determination, there is a need to increase access to health and community supports, including integration of traditional culture and healing practices. Larger study samples and qualitative research are required. Originality/value – These first published data regarding the health of Aboriginal gender-diverse Ontarians illustrate both their heterogeneity and all-too-common experiences of individual and systemic discrimination, and barriers to care. Results highlight potential impacts of colonialism and social exclusion, and suggest priorities for ameliorative action.