Download the 2022 Tool Kit
Leading & Learning WITH PRIDE A Revitalized Tool Kit on Supporting 2SLGBTQI+ Seniors (8 MB)
2004: Seniors Services and Long-Term Care (SSLTC) becomes one of the first providers in North America to embrace a model of long-term care that affirms Two-Spirit, Lesbian, Gay, Bisexual, Transgender (Trans), Queer, Intersex, and additional gender- and sexually-diverse communities (2SLGBTQI+).
2008: SSLTC releases the LGBT Tool Kit: For Creating Lesbian, Gay, Bisexual and Transgender Culturally Competent Care at Toronto Long-Term Care Homes & Services
2017: SSLTC revises the Tool Kit to share lessons about the delivery of sensitive care to 2SLGBTQI+ seniors across the City’s 10 LTC homes and community programs and provide a framework for inclusive and affirming service provision
2018: Toronto City Council adopts the Toronto Seniors Strategy 2.0; Recommendation 22 directs the City to work with community partners (The 519 and Senior Pride Network) to raise awareness and educate against homophobia, biphobia, and transphobia affecting seniors
2021: SSLTC assembles a working group of community members, service providers, allies, and advocates to revitalize the 2SLGBTQI+ Tool Kit and advance recommendation 22 in the Toronto Seniors Strategy
2022: SSLTC releases Leading & Learning WITH PRIDE: A Revitalized Tool Kit on Supporting 2SLGBTQI+ Seniors.
Advancing Respectful, Inclusive & Affirming Care
We define respectful, inclusive and affirming care as: a set of practices, policies, and principles that acknowledge the diverse experiences of 2SLGBTQI+ seniors and respond to their physical, psychological, emotional, social, and spiritual needs
- Respect is the foundation – Respect means considering the experiences of 2SLGBTQI+ seniors and upholding their rights to dignity and freedom from discrimination.
- Inclusion is the next step up – Inclusion means providing equitable access to resources and opportunities for 2SLGBTQI+ seniors, who may otherwise experience barriers and marginalization
- Affirmation goes one step further – Not only are 2SLGBTQI+ seniors respected and included, but their lived experiences and participation are actively encouraged, supported, and celebrated
Purpose of the Tool Kit
This revitalized Tool Kit strives to:
- Advance respectful, inclusive and affirming care for 2SLGBTQI+ seniors in Toronto by
- Building individual knowledge and skills among SSLTC staff and other service providers in the delivery of support to 2SLGBTQI+ seniors
- Building organizational capacity among SSLTC and other seniors support organizations in the creation of inclusive environments for 2SLGBTQI+ seniors
- Reduce stigma, discrimination, and other barriers in LTC, healthcare, retirement, homecare, and community-based services for 2SLGBTQI+ seniors in Toronto
- Meaningfully improve the lives of 2SLGBTQI+ seniors in Toronto by treating them with empathy, compassion, and dignity
Who is this Tool Kit For?
This revised Tool Kit is hosted by the City of Toronto’s Senior Services and Long-Term Care (SSLTC) division.
It includes useful examples and lessons from the 10 City long-term care homes and various community programs, but is a resource for any and all service providers and care partners working to support 2SLGBTQI+ seniors (e.g., long-term care homes, retirement homes, hospitals, social service settings, homecare agencies, other community-based organizations).
Content might also be relevant to those providing support and allyship to 2SLGBTQI+ seniors, such as family, friends, community members, caregivers, and substitute decision makers.
A Note on Acronyms, Initialisms & Language
This Tool Kit uses the initialism ‘2SLGBTQI+’ and the shorthand ‘Queer and Trans’ to describe diverse and expanding communities of gender- and sexual-minority seniors. The ‘2SLGBTQI+’ initialism was adopted following close consultation with the working group and reflects a modest step in centering the lived experiences of Two-Spirit people and LGBTQI+ Indigenous communities.
Acronyms, initialisms and language related to sex, gender, and sexual orientation are context-sensitive, imperfect, and continually evolving.
A Note on Intersectionality
2SLGBTQI+ seniors may experience stigma, discrimination, and oppression related to their age, sexual orientation, gender, race, religion, ability, socioeconomic status, and a host of other factors. These experiences can overlap and intersect to create unique barriers and challenges for different 2SLGBTQI+ seniors.
Intersectionality is a theory developed Dr. Kimberlé Crenshaw that helps us describe and analyze how the different pieces of our identity (e.g., age, race, gender, sexual orientation) intersect to create distinct experiences of privilege and disadvantage. This Tool Kit adopts an intersectional, person centered approach.
A Note on Family
In this Tool Kit, ‘Family’ is defined to include both families of origin (i.e. legal and/or biological relatives) and chosen families or found families. A chosen/found family consists of people who have intentionally chosen to embrace, nurture, love, and support one another, regardless of blood or marriage.
Preview of Section I – Building Individual Knowledge & Skills
This section of the Tool Kit provides the foundational knowledge necessary to support 2SLGBTQI+ seniors.
Specifically, this section will:
- Familiarize you with important language and terminology relevant to the care of 2SLGBTQI+ seniors
- Provide an overview of current research with 2SLGBTQI+ seniors, including their needs and experiences in LTC, healthcare, retirement, homecare, and social support settings
- Introduce the concept of 2SLGBTQI+ Allyship and outline some concrete steps you can take to practice being an ally
Language & Terminology
- Provides definitions for language and terminology related to sex, gender, and sexual orientation (e.g., Gender Identity, Gender Expression, Cisgender, Transgender, ‘Coming Out,’ Genderqueer, Intersex, Non-binary, Asexual, Pansexual, Transition, Two Spirit)
- Provides definitions for language and terminology related to Stigma, Discrimination, and Oppression Against 2SLGBTQI+ Seniors (e.g., Cissexism, Transphobia, Transmisogyny, Heterosexism, Homophobia, Biphobia, Pathologization, Colonization)
2SLGBTQI+ Seniors Today – A Snapshot of Current Research
- Explores experiences shared by some 2SLGBTQI+ seniors and provides an overview of current research on their needs and challenges.
- Topics Include:
- Historical Context for 2SLGBTQI+ Seniors – A Life Course Perspective
- Physical Health for 2SLGBTQI+ Seniors (e.g., pain, disability, asthma, certain cancers, chronic conditions)
- Sexual Health & Intimacy for 2SLGBTQI+ Seniors
- HIV/AIDS for 2SLGBTQI+ Seniors (e.g., historical trauma, stigma)
- Social Isolation and Mental Health for 2SLGBTQI+ Seniors
- Elder Abuse Against 2SLGBTQI+ Seniors
- Religious- and Faith-based Discrimination Against 2SLGBTQI+ Seniors
- Experiences of 2SLGBTQI+ Seniors during COVID-19
- Memory Loss and Cognitive Disability (e.g., dementia, HIV-Associated Neurocognitive Disorders, unique experiences of Trans people with memory loss)
- End-of-Life Care for 2SLGBQTI+ Seniors
- Barriers to Care for 2SLGBTQI+ Seniors
Practising Allyship with 2SLGBTQI+ Seniors
- Presents 6 Ways to Practise Allyship with 2SLGBTQI+ Seniors:
- Use Inclusive Language and Appropriate Terminology
- Challenge your own Biases and Assumptions
- Listen to Others and Lean into Discomfort
- Engage in Ongoing Education
- Have Challenging Conversations with Colleagues
- Advocate, Advocate, Advocate!
Preview of Section II – Building Organizational Capacity
This section focuses on organizational-level approaches to promote inclusion and address systemic barriers affecting 2SLGBTQI+ seniors.
Building organizational capacity means creating and implementing concrete policies, procedures, programs, and overall environments that explicitly respect, include, and affirm 2SLGBTQI+ communities.
Specifically, this section will:
- Identify and describe 10 recommendations for creating respectful, inclusive, and affirming organizations
- Provide practical examples and additional resources to accompany each recommendation that will empower staff to lead or support organizational change efforts
1. Look, Listen & Feel – Check the Pulse of the Organization
- Describes how to use your senses to start the process of creating a respectful, inclusive, affirming organization
- Look for signs of 2SLGBTQI+ inclusion
- Listen for 2SLGBTQI+ inclusive language
- Feel the general atmosphere of the organization
2. Spread the Word – Communicate Intentions to Stakeholders
- Provides guidance on how to identify and communicate with all the stakeholders who may be involved in or impacted by efforts to make your organization more respectful, inclusive, and affirming for 2SLGBTQI+ communities
- Emphasizes the value of framing your message using relevant policy and legislation (e.g., the Ontario Human Rights Commission) to clarify the legal obligation to provide care and support free from homophobic, biphobic, and transphobic discrimination
3. Open Up – Create Welcoming Policies, Procedures & Environments
- Outlines how to critically review your organization’s policies, procedures, and environments to ensure that they are inclusive, affirming, and respectful of 2SLGBTQI+ communities
- Provides specific instructions on embedding 2SLGBTQI+ inclusion in the following policies:
- Anti-violence, harassment, and discrimination policies
- Human resources and staffing policies
- Policies specific to long-term care and retirement settings (e.g., Resident’s Bill of Rights, Living Environments and Rooming Policies, Visiting Policies)
- Discusses 2SLGBTQI+ considerations in the following procedures:
- Intake & Assessment
- Power of Attorney and advance care planning with 2SLGBTQI+ long-term care residents
- Care planning and Essential Caregiver designations
- Highlights various visual/environmental indicators that represent an organization’s commitment to 2SLGBTQI+ inclusion, including:
- Gender inclusive washrooms
- Promotional materials
4. Light the Spark – Identify 2SLGBTQI+ Champions
- Explores the importance of 2SLGBTQI+ champions in supporting organizational change efforts
- Provides specific guidance to those in decision-making or leadership roles, who often have the organizational influence and resources to promote meaningful change
5. Come Together – Create Formal 2SLGBTQI+ Organizing Groups
- Presents successful examples of Steering Committees and Gender-Sexuality Alliances (GSAs) from two long-term are homes, which can serve as models for other organizations wishing to establish formal 2SLGBTQI+ organizing groups
6. Build Bridges – Engage Partners and Create Communities
- Explores the value of partnerships with local 2SLGBTQI+ community groups and organizations and provides an example of successful community engagement in the development of a ‘Rainbow Unit’ at the Rekai Centres
7. Hit the Books – Promote Ongoing 2SLGBTQI+ Education & Training
- Presents suggestions for ongoing education and training around 2SLGBTQI+ topics and provides recommendations on:
- Who should coordinate the training?
- Who should deliver the training?
- Who should attend the training?
- When should the training be delivered?
- What should the training include?
8. Walk the Talk – Develop and Deliver 2SLGBTQI+ Affirming Programs & Services
- Provides an overview of how to design and deliver programs and services through the lens of 2SLGBTQI+ inclusion, with a specific focus on:
- Social Support & Recreation Services
- Spiritual & Faith-based Services
- Intergenerational Programming
9. Raise Your Voice – Advocate Widely
- Discusses the importance of advocacy to shape public debate and influence policy in ways that address persistent and systemic threats to the health of Queer and Trans seniors. Presents four advocacy activities for organizations to engage in.
10. Be Accountable – Evaluate Processes & Systems for 2SLGBTQI+ Inclusion
- Highlights the critical importance of ongoing systematic evaluations to assess whether efforts to improve supports for 2SLGBTQI+ seniors are working, how, and for whom
- Explores the responsibility of an organization’s leadership and management to ensure evaluation takes place and that results actively inform strategic planning for improvement
- Draws on the learning objectives and content covered throughout the Tool Kit to develop the Respectful, Inclusive, and Affirming Care Evaluation Framework