The Victorian Government is consulting about the development of a long term, whole of government LGBTIQ strategy. cohealth supports the development of the Strategy, and emphasises the need for: an intersectional lens to be used in all actions in the strategy; the need for trans, gender diverse and non-binary awareness raising campaigns; and increased investment in the peer workforce.
cohealth welcomes the opportunity to provide comment on Victoria’s first LGBTIQA+ strategy. LGBTIQA+ people continue to experience systemic and interpersonal discrimination and research clearly links this to the disproportionately high rates of ill-health and mental illness within the LGBTIQA+ community. Discrimination must be viewed as a health issue and proactively prevented to create health and wellbeing equity. cohealth’s response calls for:
The benefits of peer work are globally understood. Evidence states that peer work results in better outcomes for consumers and organisations, in addition to providing employment opportunities for people who often face barriers to gaining employment and affirming their identity at work. Utilising the skills of peer workers within services and government is integral to improving systems, creating supportive pathways to service access and forming trusting working relationships. Whilst research on the concept of peer work is well established and understood, there remains a gap in Australian literature on the impact of LGBTIQA+ peer work and best practice frameworks.
Despite the benefits of peer work, people employed in ‘lived experience’ roles have not been adequately supported, valued or remunerated. In order for peer support services to be sustained, cohealth recommends:
1. To be able to adequately respond to community need, we must first understand what the needs are. Data collection and research continues to be exclusionary and at times overtly discriminatory against LGBTIQA+ people. One example of this was the recent decision to omit questions about LGBTIQA+ identity from the upcoming census, there by erasing LGBTIQA+ experiences through omission. At a service level, LGBTIQA+ identity is rarely included in reportable minimum data sets, resulting in services not including LGBTIQA+ identity questions at registration and client management systems not built to capture the information. LGBTIQA+ people continue to be left behind from the very first point of access, as the systems are inherently heteronormative. Understanding and improving what questions are asked, how they are delivered, and what is done with the information is the starting point to ensure the government can respond adequately to the experiences and needs of LGBTIQA+ people.
2. Having an intersectional framework to understand experiences of discrimination and oppression is essential to ensuring no one within the LGBTIQA+ community is left behind. cohealth commends the inclusion of intersectionality within the discussion paper and encourages an intersectional lens be applied to all actions within the strategy.
3. Whilst gay, lesbian, pansexual and bi-sexual identities and experiences are becoming increasingly understood within the broader community, there remains low levels of understanding and knowledge of trans and gender diverse identities and experiences, and even less so of people with intersex variations.
cohealth is currently working towards Rainbow Tick accreditation, to ensure consumers and staff experience the organisation as culturally safe and affirmative. Whilst a rigorous accreditation process is effective in embedding LGBTIQA+ inclusion, the process is inaccessible for many community and health organisations due to the large financial investment required. The cost associated with the formal accreditation, the training of all staff, resource development and staffing required to achieve Rainbow Tick is considerable.
Within the current climate of competitive short term funding, health and community services are under enormous financial pressure in addition to increased service delivery expectations. This results in limited opportunity to engage in organisational capacity building and staff development, and presents a barrier for many striving for accreditation and/or LGBTIQA+ inclusion improvements.
LGBTIQA+ people continue to experience high levels of discrimination and barriers when accessing mainstream health services and often delay seeking healthcare (LGBTI Cultural Competency Framework, 2013). There are not enough specialised LGBTIQA+ services funded to meet community need, and this high demand leads to long wait times. The lack of timely support available is a major risk to the LGBTIQA+ community, with many people choosing to either delay support, or access services that may be culturally unsafe. Both of these options have the potential to exacerbate health and wellbeing issues.
Transphobia is a major health and wellbeing issue, and needs to be proactively addressed in order to achieve equity. Transphobia is experienced overtly, covertly, interpersonally and systemically. This will continue until there is more education and understanding of diverse gender identities, and more accountability to improve systems, processes and practices across all government and non-government services.
For further information about this submission please contact:
Nicole Bartholomeusz, Chief Executive at Nicole.Bartholomeusz@cohealth.org.au.