Registed Nurses' Association of Ontario

Sexual Violence Action Plan (Ontario Women's Directorate)

Sexual Violence Action Plan (Ontario Women's Directorate)

Sexual Violence Action Plan

Submission to the Ontario Women’s Directorate

Registered Nurses’ Association of Ontario

September 24, 2010



The Registered Nurses’ Association of Ontario (RNAO) is the professional association for registered nurses who practise in all roles and sectors across Ontario. We work to improve health and strengthen our health-care system. Nurses believe that health is a resource for everyday living and that access to the conditions that permit health, including access to health care, are universal human rights. RNAO welcomes the opportunity to participate in the consultation process to support the development of a Sexual Violence Action Plan for the province.


In order to know how to prevent sexual violence, provide responsive services, and work as a system, it is essential to consider the more fundamental question of what are the conditions that make sexual violence even possible? Noted peace researcher, Johan Galtung, makes a compelling case that acts of direct violence against individuals may be most usefully understood within the context of structural and cultural violence. Structural violence refers to any constraint on human potential due to economic or political structures. Structural inequalities in access to resources and political power create inequitable access to opportunities. Cultural violence is any aspect of a culture that can be used to legitimate violence in its direct or structural forms. Underlying an individual act of sexual violence against a particular woman and underlying structural violence evident in such dynamics as women earning just 71 per cent as much as men are the cultural forces that legitimate a socially constructed hierarchy where men are ascribed greater status, value, and worth than women. The result is that women are often “seen as objects rather than subjects (or agents) in their own homes and communities, and this is reflected in norms of behaviour, codes of conduct, and laws that perpetuate their status as lower beings and second-class citizens.”


In daily life, gender relations of power often underpin unequal access to and control over material and non-material resources and unfair divisions of work, leisure, and possibilities of improving one’s life….Women have less land, wealth and property in almost all societies, yet they have higher burdens of work in the ‘economy of care’—ensuring the survival, reproduction, and security of people, including young and old.


Commission on the Social Determinants of Health on Gender Equity and Health



Commission on Social Determinants of Health Conceptual Framework


The Commission on the Social Determinants of Health’s analysis of the evidence on how to decrease health inequities leads to three principles of action:


    • Improve the conditions of daily life—the circumstances in which people are born, grow, live, work, and age.
    • Tackle the inequitable distribution of power, money, and resources—the structural drivers of those conditions of daily life—globally, nationally, and locally.
    • Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of health.

RNAO urges the Ontario’s Women’s Directorate to use the resources of the Commission on the Social Determinants of Health as both a conceptual framework to situate health inequities manifest as sexual violence and as a resource to help inform multi-level interventions across sectors. For example, an identified action area for governments to improve gender equity is to “address gender biases in the structures of society—in laws and their enforcement, in the way organizations are run and interventions designed, and the way in which a country’s economic performance is measured.” An illustration of the last point is the recommendation to governments that they “include the economic contribution of household work, care work, and voluntary work in national accounts and strengthen the inclusion of informal work.”  Canada’s ability to measure and so value the contributions of women’s unpaid work has been recently compromised by the federal government’s elimination of the mandatory long-form census.


In fact, civil society organizations report that from 2004 to 2009 there “has been a systematic erosion of the human rights of women and girls in Canada.” Canada’s ranking when compared with other countries has deteriorated: in 2004 the World Economic Forum Gender Gap Index ranked Canada 7th which slipped to 25th in 2009. Specific illustrations of the federal government’s political and institutional shift away from protection of human rights of women and girls include: the elimination of the phrase “gender equality” from the mandate of Status of Women, the primary institution responsible for gender equality in Canada; closing twelve of the sixteen Status of Women offices; elimination of funding to the Court Challenges program; and reallocation of funding from organizations that support advocacy for women’s human rights to organizations that provide only front-line services. In the midst of concerns that the Harper government is “systematically undermining women in this country” and promoting “a culture of intimidation,” perhaps the most telling incident in the Spring of 2010 was “Conservative Senator Nancy Ruth’s well-intentioned warning to some 80 aid representatives that they should shut the f--- up about abortion for fear of retribution from Harper.”


Misogyny is so pervasive and hidden in plain sight that a recent newspaper article on “breaking the cycle of car bike violence” captured the following incident. Eleanor McMahon, whose partner had been killed four years previously by a passing truck when cycling, was showing the route of a memorial “Share the Road” route to a reporter. An old pickup truck came speeding toward the cyclists so “McMahon looks toward the young driver and raises her palm in a gesture for him to slow down, but this angers him. She’s not a cop—she’s just a woman on a bicycle, in spandex. He swerves around her, barely pauses at the stop sign and peels off toward the left with a squeak of rubber. ‘Get off the f---ing road, you f---ing bitch,’ he yells.” The reporter later mentions that McMahon was “a little shaken by the abuse of the pickup driver” but his description of the incident has already built in the excuses for the outburst by characterizing the driver as young and McMahon as “just a woman” in spandex. Unremarkable as so normalized is the rage denoted by swear words associated with sexual activity and the use of the epithet “bitch” which serves to dehumanize McMahon.


Sexual assault is often mistakenly considered to be a sexual act instead of a “crime of power, control, and violence.” “Sexual violence is perpetuated by a rape culture—a system of attitudes, beliefs, messages, inequities, and acts that support sexual aggression and violence. Sexual violence occurs within a context of oppression including sexism, racism, ableism, heterosexism, ageism, and classism.” These themes may be illustrated by reports of sexual violence used against G20 Summit reporters and protesters.  Amy Miller, a free-lance journalist from Montreal, was reporting on a group of demonstrators in downtown Toronto when she was arrested and taken to the detention centre. Miller recounts a police officer telling her: “So you think you’re a journalist. You won’t be a journalist after we bring you to jail…You’re going to be raped. We always like the pretty ones. We’re going to wipe the grin off your face when we gang bang you. We know how the Montreal girls roll.” Lisa Walter, a writer for Our Times, said that she was thrown to the ground and cuffed. “She said officers mocked her, saying her credentials were ‘fake,’ questioned whether she was a man and the sergeant who ordered her arrest called her a ‘f---ing dyke’ and ‘a douche bag.’” Protester Alison Peters was told “to take our clothes off if we wanted to be taken seriously” and Skylar Radoikovic was among those who were strip-searched, called names, and threatened that “I would be raped repeatedly.” Grissel Orellana of the Toronto Rape Crisis Center describes a pattern of “chronic police violence.” “For decades we have raised concerns about police assaulting women and trans folk, and failing to properly respond to and investigate sexual assaults in the community.”


Gender-based violence is perhaps the most wide-spread and socially tolerated of human rights violations. It both reflects and reinforces inequities between men and women and compromises the health, dignity, security and autonomy of its victims.

United Nations Population Fund


Beyond the obvious problem of “outlier” peace officers assaulting individual members of the public, the casual use of sexual violence to exercise social control and power is made possible by cultural norms that are so taken for granted as to be all but invisible.


Warren Magnusson describes the ideological underpinnings of Western culture as monotheism. As a social scientist, Johan Galtung situates monotheism as a “hard religion” distinct from a “soft religion.” The hard version has among its characteristics a God that is transcendent, outside and above, and God has Chosen People. The soft version features God that is imminent, inside of all life, and People have Chosen Gods. Galtung has described transcendentalism as a “catastrophic idea” as the consequences of a God outside and above makes it increasingly possible “some people will be seen as closer to God than others.”

Some of the consequences of the metaphor of vertical distance and chosen people is that it reinforces hierarchies of all kinds including ranking humans above the rest of nature (speciesism); men above women (sexism); adults against children (ageism); whites against nonwhites (racism); upper classes against lower classes (classism, exploitation); His People against the others (nationalism, imperialism); and True Believers against heretics or pagans (Inquisition). Galtung’s description of a continuum of hardness and softness, even within traditions considered to be mainly hard or soft, helps to explain the diverse responses of care, cure, and compassion found among individuals and communities whose

motivations are influenced by the sacred.Given the global incidence of sexual abuse by clergy, it is essential to understand how the constructs of hard religion are aspects of cultural violence that legitimate direct acts of sexual violence against those perceived to be of lower hierarchical rank, including women and children.


In 1992, the Canadian Conference of Catholic Bishops issued a report, From Pain to Hope after the church and the Ontario government agreed to a $40 million compensation package for 1,600 men abused as children at two training schools near Toronto and Ottawa. More than 200 assault and sex-related charges were laid by police, which ended up in 15 convictions. This report and the earlier Winter Commission set up by the Catholic church to investigate sexual abuse at the Mount Cashel orphanage in Newfoundland both emphasized that allegations of child abuse must be treated as potential crimes and reported to civil authorities rather than be treated as internal church matters.


On December 15, 2009 the Cornwall Public Inquiry released its final report on how public institutions responded to allegations that dozens of the community’s children and teenagers were sexually abused by priests, probation officers, lawyers, and other men in positions of authority and trust. Norman Glaude, commissioner for the inquiry, found “systemic failures in the response of institutions…For some, this resulted in revictimization by the institution from whom they sought help. The response of the institutions became a further source of harm.” As a result of these findings, the Inquiry provided extensive recommendations for the Ministry of Community Safety and Correctional Services, Cornwall Community Police Services, Cornwall Community Police Services Board, Ontario Provincial Police, Children’s Aid Society, Catholic District School Board of Eastern Ontario and the Upper Canada District School Board of Eastern Ontario, Ministry of the Attorney General of Ontario, and the Government of Ontario.


Of particular concern is that the Diocese of Alexandria-Cornwall paid $32,000 to a man who came forward with his experience of being sexually abused by a priest and a probation officer while he was an altar boy in return for an agreement “not to undertake any legal proceedings, civil or criminal.” Instead of reporting the allegation of child abuse to the police for further investigation, agents of the Diocese committed a crime by obstructing justice and interfering with the criminal investigation. The priest in question was not removed from active ministry until January 1998, over five years after the original complaint.The Cornwall Public Inquiry report is replete with illustrations of senior Diocese officials enabling clergy with confirmed histories of sexual abuse to stay in roles where they were in contact with vulnerable people. Some were asked to leave a diocese for “inappropriate conduct” and then permitted to transfer to other communities without any safeguards to protect the public. Preoccupied by avoidance of scandal, Church officials failed to alert police and Children’s Aid Societies and only provided “grudging and guarded” cooperation during investigations. The Diocese did not seek out victims to determine whether they needed counseling. In response to these multiple failures, the Cornwall Public Inquiry made 25 recommendations directed to the Diocese of Alexandria-Cornwall.


Nineteen-year old Cree student Helen Betty Osborne from Norway House, northern Manitoba, dreamed of returning to her community as a teacher. She had moved to the town of The Pas, Manitoba, to go to high school. On 12 November 1971, four white men abducted her from the streets of The Pas. She was sexually assaulted and brutally murdered. Fifteen years passed before the first charges were laid against any of the perpetrators. A provincial inquiry concluded that Helen Betty Osborne was killed because she was an Indigenous woman. According to the presiding judge, the men who abducted her were driven by “vicious stereotypes born of ignorance and aggression…[They] believed that young Aboriginal women were objects with no human value beyond sexual gratification.”


Amnesty International


In the absence of accurate national statistics, the Native Women’s Association of Canada has compiled an ongoing list of missing and murdered Indigenous women based on testimony of family members and media reports. As of July 2009, the list includes more than 520 women who have been murdered or who have gone missing in the last 30 years. Amnesty International reports published in 2004 and 2009 document the “widespread and entrenched racism, poverty and marginalization” that have exposed Indigenous women to a “heightened risk of violence while denying them adequate protection by police and government services.” In addition to the recommendations outlined in these two companion Stolen Sisters reports, it is imperative that the provincial Sexual Violence Action Plan be developed with representatives from Aboriginal communities to build on A Strategic Framework to End Violence Against Aboriginal Women.


In one case, a community centre advisory board heard a report that young women were being raped on a virtually nightly basis near an outdoor hockey rink. Rather than sound the alarm, warn residents or create supports for young women to protect themselves, their instinct was to create more programs for young boys in the hockey rink so they would be distracted from assaulting young women.


Where a woman doesn’t speak English but her partner does, he is more likely to be believed or seen as credible by police and the courts....

There was a strong concern that the Police had adopted a gender-neutral attitude in dealing with male violence, and that this means women are met with the attitude that they are potential criminals, rather than getting the protection and support they need in critical moments of danger.

If Low Income Women of Colour Counted in Toronto


Ontario’s Sexual Violence Action Plan would be strengthened by an anti-racist/anti-oppression framework developed in consultation with survivors and frontline advocates working to end sexual violence across Ontario. The Ontario Association of Interval and Transition Houses have identified some practical concerns and suggestions in Survivor Voices: Welcoming women to make change. Calling on services and policymakers to include survivors in their work.


Just as we must listen intently to survivors, we also have a responsibility to learn from those who did not survive. The Association of Interval and Transitional Houses has posted jury recommendations from the Office of the Chief Coroner on the deaths of Andrew Osidacz (2008), Lori Dupont and Marc Daniel (2007), Gillian Hadley and Ralph Hadley (2002), and Arlene May and Randall Iles (1998).


The woman told the Ottawa Citizen she was turned away from the Ottawa Hospital’s Civic campus on the May long weekend because there wasn’t a sexual-assault nurse available to provide treatment….The woman attacked most recently went to the Renfrew hospital for treatment, but the woman attacked in May left the Civic and never went back. She became pregnant…

National Post, July 10, 2010


I currently work in a hospital-based community mental health and addictions program and many of the clients I see have a history of sexual violence…The average wait time for counseling is nine to ten months. Research provides the evidence that people will access services when their symptoms are most acute. Imagine being a single mother of three kids with no supports and with symptoms of depression/anxiety trying to kick an addiction while trying to maintain in the community. Now imagine being told you have to wait nine months before treatment can be initiated.


Registered Nurse with clinical expertise in community mental health



Sexual Assault Nurse Examiners have specialized educational preparation to collect and document evidence, provide counseling, and give testimony in the judicial process. Instead of staffing with full-time employees, the Ottawa Hospital was depending on on-call staff that are difficult to recruit and retain due to the precarious nature of this arrangement. Given that the pay for being on call is just $3.20 per hour unless called in and that the nurses sometimes have to fight to get paid for the time they spend testifying in court,nurses “just can’t afford” to stay with sexual assault programs.


Lack of investment in the health care system and in the health human resources required to enable access to health care is the common theme that links both stories in the box above. RNAO’s comprehensive set of policy recommendations on improving access to mental health and addiction services, enhancing medicare, improving access to nursing services, and improving health equity by addressing the social determinants of health are available in Creating Vibrant Communities: RNAO’s Challenge to Ontario’s Political Parties 2011 Provincial Election. Additional resources available to be downloaded without charge from the website of the Registered Nurses’ Association of Ontario include:


  • Best Practice Guideline  Woman Abuse: Screening, Identification and Initial Response
  • Best Practice Guideline  Client Centred Care
  • Best Practice Guideline   Crisis Intervention
  • Best Practice Guideline   Supporting and Strengthening Families Through Expected and Unexpected Life Events
  • Best Practice Guideline  Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour
  • Best Practice Guideline  Embracing Cultural Diversity in Health Care: Developing Cultural Competency
  • Best Practice Guideline  Preventing and Managing Violence in the Workplace
  • Position Statement: Respecting Sexual Orientation and Gender Identity

RNAO appreciates the leadership of the Ontario Women’s Directorate in leading the government’s efforts to create a Sexual Violence Action Plan. As we thank you for this opportunity to participate in this consultation process, we also thank our members who informed our response through participation in an online survey.



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