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.


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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.

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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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