INTRODUCTION
Zenith Foundation was established in 1993 to address the quality of life
issues for TRANSGENDERED individuals. Zenith Foundation
established its offices on French Street in Vancouver and originally
focused its energies on publishing educational pamphlets. To be effective,
the Foundation realized it should reach all classes of
TRANSGENDERED persons and that the physical, psychological and
spiritual well-being of each individual should be addressed.
With this in mind, the Zenith Foundation High Risk committee was
formed in December 1993 by Barbara H. and April V.. These two women
dedicated their energies to establishing a meal program at the First
United Church on East Hastings Street in Vancouver.
In January 1994 Sandra Laframboise joined High Risk and directed her
energies to relocating the service to DEYAS (Downtown Eastside Youth
Activity Services). She also began networking with various agencies in
the Downtown Eastside. High Risk Project opened a drop-in facility in
the Vancouver Native Health Society complex at 449 East Hastings
Street.
Understanding the need to provide holistic caring to street active
TRANSGENDERED persons, Sandra Laframboise initiated an outreach
program where she visited with TRANSGENDERED people who were
hospitalized, referred clients to various other service agencies as
appropriate, and acted as an advocate for members. She prepared a
paper on gender dysphoria for educational purposes, which now forms
the basis for a gender sensitivity training program which is offered to
local service agencies to sensitize staff to the issues of their
TRANSGENDERED clients.
In July of 1994, Deborah Brady. joined High Risk Project as Assistant
Director. High Risk Project began the process of becoming a registered
non-profit society and gave notice of eventual separation from Zenith
Foundation.
Since the fall of 1994, High Risk Project Society has been conducting
gender sensitivity training and staff seminars at several local service
agencies. The unique needs and sensitivities of the TRANSGENDERED
client are discussed. Front-line community workers are educated
regarding terminology and assessment issues, and given an overview of
services and programs in the community which are accepting and
supportive of the TRANSGENDERED street people.
BACKGROUND
In a discussion paper (Transexualism and Aids, Rekart.1992)determine
that there was 40 male transsexuals from age 20 to age 29 on the streets.
Their social conditions were homelessness, discrimination and physical
abuse. In September of 1992, the Vancouver Native Health Society called
an inter-agency meeting to explore the dilemmas of the transsexual
population. Research indicated then, that a growth in the transsexual
population to about sixty1 in the downtown Eastside was related to the
develop-ment of other areas such as Granville south and the downtown
displacement phenomenon.
The word "TRANSGENDERED" for the purposes of this paper includes
all those who self-identify within the broad scope of gender identity
disorders as defined in DSM-III-R (Diagnostic and Statistical Manual of
Mental Disorders, Third Edition, Revised - see Appendix I). The main
feature of all gender identity disorders is a feeling of incongruity between
anatomic sex and gender identity. The subgroups of those who are
TRANSGENDERED includes those who are heterosexual transvestites,
homosexual transvestites, and both primary and secondary transsexuals.
Those who most frequently end up on the streets, are excluded from
existing social services, and need a safe-place of refuge are those who
have dual diagnosis, a history of sexual abuse, and who are primary male
to female transsexuals. As well, it is those with chemical dependency,
poor social skills, poor presentation and those who suffer racial
discrimination who need this refuge.
Female to male transsexuals are more likely to follow a stable course,
with or without treatment, and the occurrence in the population is
thought to be between 0.1 and 0.3 the rate of occurrence of male to
female transsexuals. Hence, there are few female to male trans-gendered
in the street population.
Social and peer pressures toward gender conformity with regard to dress
and presentation are generally more intense for males than for females;
the frequency with which the male to female high-intensity primary
TRANSGENDERED falls between the cracks of the system is alarmingly
high.
Transvestites are frequently able to access some male privilege for a
significant portion of their lives, sufficient to hold a job and conform with
social requirements.
The primary transsexual has no such safe haven and is the most frequent
user of the services of High Risk Project. Primary transsexuals have
early onset of cross gender behavior and do not conform to the social
expectations of their anatomical gender. The consequent upset of
patterns of development and disruption of education often leaves these
people unemployable and suffering from acute deficiencies in social
skills. They are most likely to work in the sex trade, to develop chemical
dependency, and to have sexual behaviors which put them at high risk for
all sexually transmitted diseases and HIV.
Marginalization, discrimination, rejection, humiliation and violence are
common. After many years of such treatment, the defense mechanisms
become part of the self, and the individual appears sociopathic. Due to
this intense alienation, the community is difficult to penetrate, and trust
takes time to build. High Risk Project subscribes to the premise that peer
support and counsel is the best way to build a cohesive therapeutic
community.
The invisibility and marginalization of the TRANSGENDERED is
evidenced by the lack of statistical data and research. Since many
TRANSGENDERED females have male identity cards, it is difficult to
access primary data on use of services. Transgendered patients and
clients are not recorded as TRANSGENDERED, but are generally
recorded as either male or female.
In January 1994, a consumer run safe-place was established by High
Risk Project on the premises of Vancouver Native Health Society, at 449
East Hastings Street. This is and has been a peer/consumer, volunteer
run facility, and supplies are donated by local agencies. We have received
some funding in 1995-96 from the Ministry of Health HIV/AIDS division.
With our volunteer outreach program we have met within one month of
operation on the streets and in the bars 133 transvestites/transsexuals
engaged in behaviors that could lead to compromised situations. These
are:
copious consumption of alcohol
I.V drug use
prostitution
receptive anal sex with out condoms
multiple sex partners.
In the core group that we have met we have found that:
53% were prostitutes
16% were HIV+ self-disclose
100% were unemployed and on Social Assistance
80% lived in hot stove hotel rooms where the cleanliness is very poor
14% were known to be HIV+ but did not acknowledge it in any form nor
did they want to access our support group
95 % were high school drop-outs
none had contacts with family members.
Further more we have found that the ethnicity backgrounds varied:
35.5% were Aboriginal
26.5 % were Caucasian
48% were metis, malado, semantics.
The persistent medical problems we see at HRP are:
chronic cellulitis
recurring pneumonia
myoendocarditis related to their excessive use of I.V. drugs
copious consumption of black market hormones with out medical
supervision because a false believes exist that the more hormones you
take the faster the breast development will be
recently we had 4 persons with T.B.
Persistent Social issues are:
discrimination
poor access to services
homelessness
malnutrition
low education and employment
Needs Assessment reveals that:
safe place drop-in is necessary
access to detoxes and secondary treatment houses which are appropriate
housing issues must be addressed
pre-employment and job readiness training is needed
social cultural teachings is needed
reserves needs education on issues face by the aboriginal
TRANSGENDERED individuals
Native agencies need to respect the individual where they are at and to
encourage the education of what gender dysphoria is which it is the
condition a transsexual suffers.
comprehensive social research and needs assessment involving the
aboriginal communities is needed.
Until these issues are addressed we at HRP believe that their will be no
reduction in the rates of HIV/AIDS infection as evidenced by the
behaviors of our members.
HIGH RISK PROJECT SOCIETY 449EAST HASTINGS STREET, VANCOUVER B.C., V6A 1P5 Tel;(604)255-6143 - fax;(604)255-0147 - email; hrp@direct.ca
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