Statistics Canada estimates that there are approximately one million Canadians aged 15 years or older who identify as sexually or gender diverse (2SLGBTQI+). It is hard to determine an exact number because the adequate and longitudinal data needed are lacking.
Advocacy by and on behalf of 2SLGBTQI+ communities has accomplished much in recent decades, including the legalization of same-sex marriage in 2005, and the explicit protection of gender expression and identity in the Ontario Human Rights Code in 2012, followed by the Canadian Human Rights Act and the Criminal Code in 2017.
Sexually and gender-diverse people and communities, showing their ongoing resilience, have long advocated for their health needs and to obtain acknowledgment of their health concerns from scientific bodies and government. However, gaps still exist when it comes to their health-care options and outcomes. The physical and mental health inequities which still exist are often experienced differently by 2SLGBTQI+ people. Their health outcomes are also impacted by the intersection of gender identity, gender expression and sexual orientation with other determinants of health such as age, income, disabilities, ethnicity or race.
RNAO recognizes that these injustices remain deeply ingrained in the health system and in workplace settings, academic institutions, professional associations and other structures affecting health and wellbeing. We are committed to working with health organizations and communities across Ontario to create change through advocacy, support and education.
Our goals are to challenge invisibility and silencing faced by 2SLGBTQI+ people, to facilitate evidence-informed nursing care that reflects the needs of 2SLGBTQI+ clients, and to advocate for 2SLGBTQI+ clients and provide resources, support and knowledge for nurses, their communities and each other.
A note about our chosen acronym
We have chosen to use the acronym “2SLGBTQI+” to represent as broadly as possible a diverse group of unique people with respect to sexual orientation, gender identities and expressions. The letters in the acronym stand for Two-Spirit, lesbian, gay, bisexual, trans, queer and intersex people. The “+” is meant to be inclusive of other people who identify as a sexual or gender minority, for example, asexual, non-binary, pansexual and those questioning their sexual orientation, gender identity or gender expression.
We acknowledge that histories of oppression and privilege, erasure and violence against those who belong to 2SLGBTQI+ communities cannot be easily reflected in any acronym claiming to describe sexually and gender diverse groups as a whole. The 2SLGBTQI+ acronym currently used by RNAO was selected to capture the range of sexually and gender-diverse communities in Canada and around the world. “2S” was chosen to lead the acronym as a way to honour and bring visibility to Indigenous Two-Spirit people.
2SLGBTQI+ position statement
On June 26, 2021, RNAO along with RNIG shared a revised position statement on respecting sexually and gender-diverse communities.
"The statement underscores the need to ensure sexually and gender-diverse individuals feel safe when accessing care and their experience is person-centred, inclusive and appropriate."
Rainbow Nursing Interest Group
Since 2007, RNAO’s Rainbow Nursing Interest group (RNIG) has supported the 2SLGBTQI+ community. RNIG values evidence-informed, inclusive, reflective, respectful, safe and supportive care and environments for people of all sexual orientations and gender identities and expressions.
RNIG’s mission is to foster and advocate for nursing practice and environments that support people of all sexual orientations and gender identities and expressions.
RNAO speaks with then RNIG President Dr. Paul-André Gauthier
Shelly Evans, RN, MScN, PhD(c)
Dr. Paul-André Gauthier, Inf./RN, CNS, DMD, MN, PhD (nursing)
Ruth Trinier, MN, NP
Sheena Howard, RN, BScN, MA
RNAO 2SLGBTQI+ BPG Expert Panel Co-Chair
Dr. Elizabeth M. Saewyc, PhD, RN, FSAHM, FCAHS, FAAN , FCAN
RNAO 2SLGBTQI+ BPG Expert Panel Co-Chair
Members can make their voices heard and help mobilize change by submitting resolutions to the association for consideration.
Sexual and Gender Minorities Content in the Nursing Standards
A call to action for governments and health-care leaders to include the health needs of sexual and gender minorities into entry-to-practice competencies and nursing school curriculums.
Re-implement the 2015 Sex Education Curriculum
A call to action for RNAO to continue to encourage RNs and NPs working in educational settings at the primary, secondary and tertiary levels to teach and work under the provisions of the 2015 sex education curriculum and as such seek to be inclusive of all gender and sexual identities and expressions.
Best Practice Guideline
Promoting 2SLGBTQI+ Health Equity BPG
This BPG provides nurses and other members of the interprofessional team with evidence-based recommendations on foundational, inclusive and affirming care practices for 2SLGBTQI+ people.
This BPG is also to be used to enhance the safety of health-service organizations, schools and academic organizations for 2SLGBTQI+ communities through the adoption of evidence-based practices.
Safe and inclusive environments enable nurses and other members of the interprofessional team to improve access and optimize health outcomes for those receiving care.
Hassle Free Clinic
Hassle Free Clinic is a community-based clinic providing medical and counselling services in all areas of sexual health. It is the largest anonymous HIV test site in Canada, and is one of the country’s busiest sexually transmitted infection (STI) clinics. Hassle Free Clinic recognizes the unique sexual and reproductive health needs of trans and two-spirit people and people of trans experiences.
Rainbow Health Ontario
A program of Sherbourne Health, Rainbow Health Ontario (RHO) offers training for health-care providers across the province to feel more clinically and culturally competent in caring for their 2SLGBTQI+ service users. RHO also supports system change by producing evidence-based print and web resources, contributing 2SLGBTQI+ health perspectives to public policy processes, acting as a research catalyst and hosting Canada’s largest 2SLGBTQI+ health conference.
Sherbourne Health Centre
Since 2007 Sherbourne Health Centre has been serving clients through its Family Health Team, made up of nurses, mental health counsellors, physicians, outreach workers, dietitians, client resource workers and health promoters.
Sexual Health Ontario
Sexual Health Info-Line Ontario (SHILO), also known as Sexual Health Ontario, is a province-wide free anonymous counselling, information and referrals to sexual health clinics and community agencies about HIV/AIDS, sexually transmitted infections, birth control options, infertility, sexual orientation and gender issues.
Trans Wellness Ontario
The mission of Trans Wellness Ontario is to enhance and sustain the health and wellness of transgender, genderqueer, Two-Spirit, non-binary, queer and questioning communities and their families.
Two-Spirited People of Manitoba Inc.
Established in 1986 in Winnipeg, The Two-Spirited People of Manitoba is a community-based organization focused on helping Indigenous LGBTQ/Two-Spirit people improve their lives. Supported by tireless volunteers, they provide awareness workshops, organize community events and advocate to prevent homophobia and transphobia.
Wisdom2Action (W2A) is a social enterprise and consulting firm specializing in community engagement, creative facilitation, research and evaluation, knowledge mobilization and equity, diversity and inclusion. W2A is a proudly 2SLGBTQI+ owned and operated firm, with a deep commitment to anti-oppression and social justice.
Every year, RNAO and its members participate in Pride festivities across the province.
From Kingston to Toronto, RNAO and its members have participated in parades to speak out against discrimination and social exclusion based on sexual orientation and gender identity.
We continue to stay committed to celebrating diversity, inclusivity and equality.
Pride Parade photo gallery
Below is a list of RNAO members and staff at various Pride events all over the province during the last few years.
Pride Parade Toronto 2022
In 2015, RNAO in conjunction with RNIG put on a webinar series related to issues and health care for 2SLGBTQI+ individuals and health-care professionals. Topics included an introduction to LGBTQ culture and terminology as well as how to support trans clients and colleagues.