It is an expectation that all Toronto Public Health staff adhere to the following Philosophy and Guiding Principles when engaging in work related to sexual health.

The Philosophy and Guiding Principles are to be understood within a population health perspective that emphasizes the social determinants of health. Toronto Public Health strives to work and deliver programs within a framework that acknowledges the historical, ongoing, complex and intersecting effects of unjust and excessive power, affecting how we are treated in society and how we treat each other. People and communities are oppressed based on real or perceived identities and experiences ¹. TPH values the lived experiences of individuals from diverse communities and backgrounds in the planning, development and delivery of all our projects and programs.

The primary goal of the Sexual Health Program is the prevention of unintended pregnancy and Sexually Transmitted Infections (STIs). Sexual health promotion, however, is much more than this. Sexual health promotion supports decisions not to participate in sexual activity. Sexual health promotion also supports decisions to participate in consensual sexual activity, and decisions about whether, how and when to have children. Our sexual health promotion goal is to promote a satisfying, safe and pleasurable sexual life, while reducing harm, judgement, shame, guilt, coercion, and abuse.

Sexuality is an important part of every human being, encompassing not only how we act, but also how we think and feel. It is strongly shaped by our experiences, attitudes, values and beliefs. Over the lifespan, sexuality may include the basic needs for touch, intimacy and connection, emotional expression, love, and pleasure.

People make sexual choices within a complex set of social systems. Sexual expression and decision making takes many diverse forms. Healthy sexuality cannot be separated from basic human rights - freedom from discrimination, harassment and violence. TPH staff respect these basic human rights and advocate when these rights are denied.

Respect for all individuals within diverse communities is an essential part of our healthy city, and is supported by quality sexual health promotion strategies. These strategies include advocacy, community capacity building, environmental support, health education, healthy public policy, re-orienting health services, self-help, and social marketing.

Pillars of Practice

Sexual health promotion, education and counselling are an integral part of the following programs at Toronto Public Health (TPH):

• Healthy Communities
• Healthy Families
• Communicable Disease Control
• Planning and Policy

TPH practice and programming is informed by:

• Toronto Public Health Diversity, Access and Equity
• Toronto Public Health Practice Framework
• City of Toronto Human Rights Office
• City of Toronto Drug Strategy (PDF)

The following principles frame the work and policy of the Sexual Health program:

1. Sexual Health promotion is rooted in Knowledge Transfer and Exchange that includes:
   1. Cross-disciplinary knowledge-based practice

      TPH staff explores and responds to the needs of unique communities while ensuring that programs are grounded in theory, available research and experiential knowledge.

   2. Research

      TPH staff participates in and foster inclusive and equitable networks that promote knowledge sharing, facilitate communication, and encourage a culture of innovation and change.

   3. Evaluation

      TPH staff continually searches for innovative best practices to improve our programs using research and evaluation.

      In order to provide efficient and innovative health care delivery, we include partner and stakeholder engagement in these three planning processes

2. Harm Reduction

   TPH staff responds to substance use in ways that do not demand abstinence, seeking instead to reduce associated harms. We respond to the needs and priorities of individuals using substances, as well as their families and communities.

3. Risk Reduction

   TPH staff responds to sexual activities in ways that minimize risk and change behaviour, while responding to the needs, priorities and choices of individuals and communities with respect and non-judgement.

4. Community participation and development (Community Capacity Building)

   TPH staff learns and works in a skills exchange process with our community partners to mutually identify and develop sustainable responses to emerging and ongoing sexual health issues.

5. When educating or counselling about sexual health issues, all Toronto Public Health Staff are:
   1. Bound by TPH policies on confidentiality
   2. Inclusive/Respectful/Non-judgemental

      TPH staff emphasizes the self-worth, self-determination and dignity of all individuals.

   3. Two spirit, transgender, transsexual, questioning, queer, lesbian, intersex, gay, bisexual, and asexual positive and inclusive

      TPH staff understands that sexual orientation and gender identity is an integral part of every human being, sometimes fluid, sometimes fixed. We include, acknowledge and celebrate all gender identities and sexual orientations in our programs, policies and written materials.

   4. Advocates

      TPH staff acknowledges the strength of individuals, groups and communities and work with them and/or as their allies to bring their sexual health needs and concerns to all levels of government.

   5. Pro-choice

      TPH staff provides information on all pregnancy options (continuation, adoption and abortion services). This is critical when clients are unsure about their available choices and resources.

6. Sensitive to the complexities of facilitating disclosure when counselling about:
   1. HIV/AIDS

      TPH staff is clear that HIV positive clients have a legal obligation to disclose their HIV status to sexual partners and practise risk reduction strategies. Since it may not always be safe to do so, we assist with disclosure. While we strive to support individual rights, TPH staff will ensure the protection of the public.

   2. Sexual/Physical Abuse

      TPH staff has a legal obligation to report suspected and disclosed sexual/physical abuse for those 16 years of age and under (or 18 years of age and under, if in protected custody).

   3. Sexual Orientation/Gender Variance

      TPH staff supports the autonomy of individuals in deciding if, when and to whom they wish to disclose.

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¹Some of these identities/experiences are included here, representing the foundation of our Sexual Health Philosophy and Guiding Principles:

Age, Ancestry, Citizenship, Class, Colour, Creed, Cultural status, Education, (Dis)Ability, Ethnic origin, Faith, Gender identity, Gender presentation, Geographic location, Housing status, Insured/uninsured, Language, Literacy level, Marital/family status, Nationality, OHIP status, Parental/care giver status, Place of origin, Political affiliation, Racialised identity, Receipt of public assistance, Religion, Sex, Sexual identity, Sexual orientation, Socio-economic status, Work status.