Category: intersectionality

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Anti-Oppression Anti-racism work Equity Health Care intersectionality lactation LGBTQ2S+ surrogacy understanding bias

Reflections on Trans Inclusion in Birth & Lactation Support

Response re Inclusive Language

Miriam Main, one of the directors of La Leche League Great Britain (LLLGB) recently resigned because she objects to the organizational directive to be inclusive of all people who lactate, regardless of sex or gender identity. Her open resignation letter explaining her decision echoes much of the feedback we’ve heard in recent years from birthworkers who disagree with our use of language such as “chestfeeding”, “birthing person” and other terms aimed at ensuring that all people who birth babies and feed infants from their mammary glands feel included and supported with the resources required to meet their feeding goals. 

Her objections to trans inclusivity include:

  • Women cannot be physically and emotionally open with “men” present
  • Men will make LLL meetings unsafe
  • It might be dangerous for men to feed babies
  • Men feeding babies separates them from their mothers, causing damage to the mother-baby dyad.

November 20 is Trans Day of Remembrance. The day was founded in 1999 in protest of the murders of two Black trans women, Rita Hester and Chanelle Pickett. There is heightened tension regarding this day this year because of the US election outcome. Trans people in the US and elsewhere are deeply afraid that emboldened transphobes will be incited to violence. Further restrictions on trans people’s ability to access affirming care is likely coming. The inability to access gender-affirming care increases suicidality among trans people. While Main claims that she is not anti-trans rights, unfortunately, rhetoric like Main’s fans the flames of fearful and hateful myths putting trans lives in danger.

The Confusion About Main’s Objections

Main is against the presence of “men” at LLL meetings. Confusingly, she includes transmen and non-binary people in a list of types of “women” she has effectively supported at LLL meetings in the past as a leader. When she uses the term “men” she could be referring to trans men who gave birth to their babies or trans women using the lactation induction protocol to assist with feeding their babies. Through this confusing use of language, Main appears to be asserting that trans men are “women” and that trans women are “men”.

Main’s view is rooted in an idea called “gender essentialism”. This is the belief that there are two genders, that gender and sex are the same, and that the characteristics of the genders are an innate, hardwired aspect of our biology. While many people subscribe to this normative view, there is a growing body of evidence that it is scientifically inaccurate. Since the dawn of recorded history, in cultures around the world, there have been people who don’t fall into the binary sex and gender categories of “man/male” or “woman/female”. Many cultures have acknowledged more than two genders. Now science is catching up with these age-old lived experiences. 

Main’s statement recirculates several myths that we as birth workers need to dismantle:

Women Cannot be Physically & Emotionally Open with “Men” Present

Main argues that it would be impossible to maintain the open, honest environment of LLL meetings if men were present. How could women feel comfortable talking about things like chapped and mangled nipples, or nurse in front of others if men are present? Main doesn’t realize it, but she answers her own question. She notes that breastfeeding is “the great leveler”. She observes that LLL group participants put aside differences regarding race, religion, income, politics, and sexual orientation. They are united in their shared goal of feeding their babies from their bodies. Whether participants are cis women, trans men, or trans women they are all dealing with chapped nipples, sleepless nights, and internal and external pressure to use bottles. Imagine the world we’d be living in if we developed our ability to focus on what we share rather than what divides us.

Men Will Make LLL Meetings Unsafe

She also fears that women may not feel comfortable coming forward about domestic violence if men are present, noting that 1 in 4 women have experienced intimate partner violence. A Canadian study of trans people conducted in 2019 found that 3 in 5 trans women had experienced intimate partner violence. Contrary to some of the rhetoric surrounding the recent US election, trans women are not usually the perpetrators of violence. They are in the population that is at increased risk of experiencing gender-based violence. Cultivating the erroneous belief that trans people are a source of violence is a significant inciter of violence against trans people. This needs to stop immediately.

Damage to the Mother-Baby Dyad

The letter raises safety concerns that are fear rather than fact-based. She posits harm to mothers and babies caused by ripping babies from their mothers’ arms so that men can feed them. Like much of what is fueling the current trans panic, this is a total red herring. Babies are not being ripped from their mother’s arms so that men can feed them. In the case of trans men, they are usually the gestational parents of their babies. Non-gestational parents with breast tissue can induce lactation. This includes cis women, trans men, and trans women becoming parents through adoption, surrogacy, or their partner carrying the baby. The protocol to induce lactation is rigorous, involving high doses of hormones and domperidone for several months before the birth. In cases where nursing is shared between a gestational and non-gestational parent, this is with the consent of both parents. For anyone who has fed a baby with their body, it should be easy to see why sharing the load of this labour might be desirable. 

Regardless of the exact nature of the situation, it’s safe to assume that anyone showing up to feed a baby at a La Leche League meeting is a parent to that baby. That’s really all that should matter.

It Might be Dangerous for “Men” to Feed Babies

She asserts that it might not be safe for babies to be fed by a “man”. She cites no evidence of any safety concerns. This is because there is none. Aside from universal precautions regarding substance use or infectious disease, If milk comes from your nipples, you can feed it to a baby. Where supply is inadequate to meet the baby’s nutritional needs, this can be addressed as it would be for anyone. We all know how frustrating and overwhelming supply issues can be. Parents experiencing this challenge need more compassion and support, not less.

There’s no reason to believe that trans lactators are at increased risk of under-supply or babies that are failing to thrive. In response to Main’s open letter, IBCLC Ashley Pickett has shared some helpful research. She notes that “When people take hormones, they can still breastfeed. It hasn’t been shown to be dangerous. Many AFABs [assigned female at birth] are entering menopause, and breastfeeding while on HRT [hormone replacement therapy]. Some trans women have taken estradiol and domperidone and their breastfed babies thrive.”

The potential for trans women to lactate and nurse is a new phenomenon, and as such, bound to raise concerns. Ashley Pickett, IBCLC addresses this with the best available evidence also. She cites two articles showing no cause for concern at this time:

https://pubmed.ncbi.nlm.nih.gov/37138506/

https://pubmed.ncbi.nlm.nih.gov/7462406/

Drawing from the articles she cites, she also provides evidence to allay fears that hormones are crossing over into the milk supply and causing harm to babies:

“Spironolactone is poorly excreted into breastmilk and there are no reported adverse effects on infants.

Cyproteone Acetate (used for [male to female] transitions as well as more commonly for acne and hirsutism, alopecia, etc) in people [assigned female at birth] transfers at 0.2% of the parental dose. However, in trans HRT uses high doses. Switching to an injectable Estradiol Valerate may be enough to elevate estrogen and not require an anti-androgen, and safely breastfeed. Breast development would remain, but she may grow some unwanted hair.

GnRH treatment has been used in postpartum contraception for decades, and in this time, has been shown to be as low as undetectable in milk and up to 1-2 micrograms per feed at max. The amount ingested had no biological activity in the infant (would be destroyed in the gut before entering the system). When taken throughout pregnancies, as it has been for many many experiencing fertility care since the 1990s, there has been “no specific hazard observed” among newborns exposure.”

 ~

The REAL issue

Evidence has nothing to do with Miriam Main’s underlying fear. It is the same as that of our members complaining about our use of gender-inclusive language. She is afraid that she and her fellow cis women are being erased from spaces that should feel like home. While this fear is an understandable conditioned reaction to change, it is unfounded. Cis women continue to comprise the majority of people who birth and lactate. Our use of inclusive language is an action to begin opening the door for trans and non-binary people who birth and lactate to receive affirmation and support. For cis women reading this, take a moment to imagine what it would feel like to walk into an LLL meeting knowing that there will probably not be anyone else in the room who is like you, but you need help feeding your baby all the same. Would you be brave enough to walk into that room? Would you be grateful for any gesture that made it a little easier?

Letting trans folks in doesn’t erase us as cis women. It is not usually presented this way, but trans inclusion and acceptance create more freedom for cis women. As we dismantle rigid, binary gender constructs and break down boundaries regarding what a “woman” can or should be, we are all freer to express ourselves authentically. I was raised in a family of women who couldn’t leave the house without “putting their faces on”. Now, I wear makeup when I feel like it. I speak truth to power without hesitation because I’m not limited by the belief that being a “woman” requires passivity. Every day I engage in numerous actions that I take for granted that would have been unthinkable for a Black woman a century ago. I owe a huge debt of gratitude to racialized trans ancestors, like Marsha P. Johnson and Sylvia Rivera, who started the Stonewall Riots, and with them, the queer liberation movement in North America.

If we let go of the fear of erasure, we can invite in the potential for trans people to enrich birth and lactation spaces. We may discover that the experiences of trans people add an important perspective on issues affecting all of us who experience gender oppression and gender-based violence. Community support and mutual aid are not finite resources. We don’t have to worry that by making space for trans people, cis women will be squeezed out. There is room in the circle for everyone.

 

About the Author

Keira Grant

Keira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.

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community Equity intersectionality

Response to the Consensus Statement on the Management of Intersex Disorders

intersex families

[vc_row][vc_column][vc_column_text css=”.vc_custom_1731959260366{margin-bottom: 0px !important;}”]This year, in the course of my prenatal and birth support work, I had the occasion to read The Consensus Statement on the Management of Intersex Disorders published in 2006. Now eighteen years old, the Consensus statement is still used by medical teams to guide ethical decision-making regarding the medical care of intersex newborns, infants, and young children. 

Given this, doulas should be familiar with this Statement and ready to provide informational support to parents that is free from stigma and based on current evidence, including the stories of intersex adults. There are numerous concerns with this statement from a health equity and intersectional social determinants of health perspective. Many issues arise from how dated the document is. There are four problem areas with this statement: 1) Guidance on Terminology, 2) Guidance on gender assignment, and 3) Lived experience of intersex people not valued as evidence 4) The Kenneth Zucker controversy. 

Guidance on Terminology

The term “Intersex” is used in the article title, however, in the article body it lists “intersex” as potentially pejorative alongside several outdated and offensive terms. It then goes on to advise providers that “Disorders of Sexual Development” is the preferred term. This differs from the position of advocacy groups by and for intersex people, who counsel their audience that “intersex” is the term they prefer. 

Intersex conditions are numerous and diverse. Framing all of them as disorders discounts the reality that many intersex people are able to have sexual relationships and children without ever needing medical intervention. The universal use of the term “disorder” insinuates that all intersex people have something “wrong” with them that needs to be corrected. This is simply untrue. Some intersex conditions can cause issues with the ability to eliminate urine, in which case this must be treated as soon after birth as possible. Other conditions may impact fertility, and sexual functioning, or increase the likelihood of having cancer later in life. None of these issues need to be treated during the newborn phase and parents should be encouraged to focus on bonding with their baby. The blanket use of the term “disorder” and the fear it is apt to inspire in parents does not support the measured and stigma-free approach to decision-making that is best here. 

Guidance on Gender Assignment

Unsurprisingly given the statement’s age, concepts like non-binary identity and gender-open parenting are not entertained. The Statement positions it as a given that parents will be deeply disturbed if they are not able to assign a gender to their baby at birth. It promotes making a gender assignment as quickly as possible after birth as the way to alleviate parental anxiety. Much of the pressure to diagnose and treat early that it advocates is rooted in the belief that parents need guidance on how to assign gender. The statement then offers guidance on what gender should be assigned to people with certain conditions.

The idea that each individual is the most qualified person to identify their gender is never considered. According to the statement assigning gender is strictly the purview of the parents, in this case, guided by medical experts. 

Earlier this year, I wrote about the concept of “gender-open parenting” and how and why it is enacted. This approach to parenting is guided by the belief that each individual has the right to assert and express their gender as free from external pressure as possible. Gender-open parenting is a wonderful option for parents of an intersex child to consider. Gender formation and expression happen in early childhood. Anecdotally, most children who have been raised gender open have self-identified their gender by the time grade one is over. At this age, most medical complications will not have arisen, and most medical interventions are still on the table. From the standpoint of promoting bodily autonomy and informed consent, parents should be encouraged to defer decisions about gender assignment and non-urgent medical intervention until the child can be a part of those conversations.

The Lived Experiences of Intersex People

More recent research on intersex people has found that many intersex adults have extensive medical trauma from repeated examinations and in some cases multiple surgeries during childhood. Moreover, many intersex adults attest that the surgeries they endured were cosmetically motivated, medically unnecessary, and in some cases harmful to their sexual functioning and/or fertility. Still, other intersex people whose parents forewent medical interventions state that they are happy, functional adults. 

This qualitative evidence from intersex adults needs to be viewed as legitimate evidence regarding how intersex people should be cared for in childhood. I’m not sure how much qualitative evidence from intersex adults existed in 2006, but if there was any, it wasn’t included in the statement. 

The statement does use statistical evidence drawn from intersex adults, using the gender identity held by the majority of individuals with specific conditions to justify assigning that gender to all infants with that condition. The Statement notes that gender may need to be reassigned if the initial assignment proves wrong. Again, the experts are to make this reassignment. The concept of the individual deciding their gender for themselves is not mentioned. 

Throughout the document, the intersex child is discussed as a passive bystander to their health care decision-making. This is not aligned with contemporary approaches and attitudes regarding the importance of client-centred and directed care, informed consent, and bodily autonomy that should be enacted in every part of the healthcare system.

Kenneth Zucker Controversy

The Statement is a consensus among international experts on the diagnosis and management of intersex conditions. The Canadian expert who contributed to the statement is Dr. Kenneth Zucker. His name will ring a bell for many members of the Toronto 2SLGBTQ community, especially trans people, parents of trans kids, and their allies. For many years, Dr. Zucker was the director of the Gender Identity Clinic at the Centre for Addiction and Mental Health (CAMH). Many trans youth and their parents have accused Dr. Zucker of harming them by gaslighting them about their gender identity and trying to convince kids who were certain that they were trans that they were wrong and that in his expert opinion, they were cisgender and should focus on being comfortable with the gender they were assigned. Following significant and sustained outcry from the 2SLGBTQ community alleging conversion therapy, Dr. Zucker was relieved of his duties at CAMH, and the Clinic was closed. He defended his practices, appealed this decision, and was eventually offered an apology and a settlement by CAMH.

The consensus statement manifests many of the concerns that were raised about Dr. Zucker’s ideology. They included:

  • The individual is not considered a valid authority on their own lived experiences and identity. 
  • Conforming to the gender you are assigned is the ideal outcome. 
  • Non-binary, genderqueer, agender, and genderfluid identities are not legitimized or even considered. 
  • Everyone must eventually conform to the box of “male” or “female”. 
  • Gender is something that is assigned to you, not something that you define for yourself. 
  • Having a child that can’t be easily slotted into one of those boxes is “disturbing” for parents.

On this platform, I have talked about how these beliefs are harmful to trans people. They’re harmful to intersex people too, especially in infancy. The pressure to rush to gender assignment, potentially reinforcing the assignment with surgical procedures, is driven by these beliefs. Intersex people are being physically and psychologically harmed as a result. 

~

For many parents, their child being diagnosed with an intersex condition will be the first time they have given any thought to the existence of intersex people. This is through no fault of their own. The gender binary is the dominant perception of reality. The lives of intersex people are shrouded in stigma and silence. As such, parents are highly vulnerable to accepting what they are told by medical experts at face value. The Consensus Statement is an excellent example of how medical guidance is not always objective. Our interpretation of “facts” is always mediated by our preexisting beliefs. 

Doulas have a vital role to play in helping parents understand where medical recommendations are coming from and unpacking the beliefs on which seemingly evidence-based recommendations rest. The B.R.A.I.N (Benefits, Risks, Alternatives, Information/Intuition, (do something) Now/Never/Not Now) model of decision-making is an excellent approach to apply. We can also reduce stigma by sharing stories of positive outcomes for intersex individuals. Role models and other resources can be found at Intersex Canada or InterAct: Advocates for Intersex Youth.

My social media post from October 28, 2022, offers guidance on specific questions parents should ask if their child is diagnosed with an intersex condition. A huge part of the magic of this work is the power to improve lives by being at the ready with unbiased, affirming, open-minded information and compassionate support. If we lead with compassion and inclusiveness, we can alleviate the medical harms currently happening to intersex babies and children. 

 

Keira GrantKeira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][/vc_row]

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Anti-Oppression Anti-racism work Canada collaboration community decolonization Equity indigenous doula intersectionality national indigenous peoples day

Land Back, Bodies Back

Indigenous standing on the dock of a lake and greenary

[vc_row][vc_column][vc_column_text title=”Land Back, Bodies Back” css=”.vc_custom_1717529147132{margin-bottom: 0px !important;}”]Many settlers (i.e. all non-Indigenous residents on Indigenous land) are resistant to the Land Back Movement. Misinterpreting “Land Back” as a call for all settlers to “go back where they came from”, they often get scared, then angry.

I am a Black settler on Turtle Island and I support the Land Back Movement. I certainly have no intention of “going back where I came from”. Aside from the fact that this would split up my interracial family, my ancestors hail from a Caribbean island wherein there are more of us in the diaspora than there are living on the island. If all of us who are now settlers elsewhere suddenly “returned” this would lead to social chaos and economic collapse.

Land Back isn’t symbolic either. It is about restoring the stewardship of this land and its resources back to Indigenous people, ensuring they have self-determination. It’s about changing the narrative such that Indigenous ways of knowing and doing become the status quo.

I am ride or die for a Turtle Island stewarded by Indigenous leaders. Climate change is heating up quite literally, with “wildfire season” starting earlier with bigger outbreaks each year. There is growing talk of returning to Indigenous “controlled burning” practices to mitigate the devastation. Indigenous communities were forced to abandon the practice because their colonizers thought controlled burns were “barbaric”. It’s one of countless examples of traditional resource stewardship practices that were abolished to the detriment of all.

The Canadian state has a long history of interpreting its treaties with Indigenous nations in bad faith. Settler-colonists spuriously interpreted the land as meaning nothing more than the ground we are standing on. Where treaties have designated the land to specific nations, the state and its agents have still felt entitled to help themselves to the resources on that land, including plants, water, minerals, and animals.

Indigenous nations have a more holistic understanding of the land. Everything the land produces is part of the land and the Indigenous elders representing their people signed the treaties with that pragmatic worldview. Seen in this way, our bodies and families are also part of the land. As such, reproductive and perinatal health and services are significant arenas for the Land Back movement.

Indigenous midwives and doulas are at the forefront of actions to decolonize and reclaim birth. Here are a few examples of their initiatives that are bringing Indigenous birth back to the land:

 

  • Konwati’shatstenhsherawi’s means “Women are Giving Each Other Power” in the Mohawk language (Kanien’kéha). This collective trains Indigenous birth helpers to support birthing people using ancestral worldviews and practices. Since the grassroots program’s inception in 2017 demand has been high and the 4-person training team is busy teaching new cohorts all the time.

 

  • Call Auntie is an Indigenous-led sexual and reproductive healthcare clinic operating weekly at Toronto Birth Centre, and as a pop-up at other locations around the city. They offer a holistic suite of services rooted in traditional Indigenous knowledge, including mental health, primary care, and social support programs. Their service model emphasizes problem-solving, removing barriers, and community-led care.

 

  • Pauktuutit Inuit Women of Canada is making important strides forward in expanding access to traditional midwifery in remote northern communities. Their position is that this access is a health and cultural right for Inuit people. They recently published a report finding that governments do not provide adequate financial support to culturally safe sexual and reproductive health care. They advocate for an end to forced birth evacuation and a return to traditional birthing practices on the land.

 

  • Mālama Nā Pua o Haumea is a collective of Hawaiian traditional midwives who are working to reduce maternal mortality rates which are higher in Hawaii than in the continental US. Recently, legislation governing midwifery care has changed and they are now required to become certified nurse midwives (CNM) or certified professional midwives (CPM). Pale keiki (traditional Indigenous Hawaiian birth attendants) experience multiple institutional barriers to completing this certification, including cost and relocating to an urban centre. In contrast to these 4-year certification programs, pale keiki train with a mentor versed in intergenerational knowledge for over a decade. Some pale keiki are continuing to provide culturally safe care in Pidgin, despite these legislative changes. (US)

 

  • Kehewin Cree Nation has launched a program to train traditional midwives and has received federal funding to open a birth center on its territory. The nation aims to see more Cree babies born on their land and to honour sacred traditions such as placental ceremonies. Trainees in the program learn the knowledge of their midwife ancestors alongside Western medical knowledge. Four women are in the inaugural cohort and the program will take up to 4 years to complete. Kehewin Cree Nation anticipates these 4 trainees will be the first of many.

 

 

Keira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][/vc_row]

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Anti-Oppression birth Canada community Equity fear intersectionality LGBTQ2S+ pride reducing stigma sexual health shame

The Importance of Being Seen: Trans Day of Visibility & Pink Shirt Day

[vc_row][vc_column][vc_column_text title=”The Importance of Being Seen: Trans Day of Visibility & Pink Shirt Day” css=”.vc_custom_1714091548194{margin-bottom: 0px !important;}”]

 

When I was a kid, we were taught that not seeing differences, or being “colour-blind” was the right way to be “tolerant” and “accepting” of diversity. We hear echoes of this sentiment when we hear “They can do whatever they want behind closed doors, but why do they have to flaunt it in our faces?”

March 31 was Trans Day of Visibility and April 10 was International Day of Pink. Both observances attest to the importance of being seen as an integral dimension of human rights and inclusion. People who can only be their authentic selves behind closed doors can’t hold their same-sex partner’s hand during the anatomy ultrasound, or tell their care team that they want to be called “Papa” after they give birth. People who are forced to hide their identity behind closed doors are at risk of getting beaten up in bathrooms and dying by suicide behind closed doors. Trans people need to be seen so that kids like Nex Bennedict can go to school safely. Behind closed doors is exactly where abuse and violence hide.

Having safety to be seen means being able to fully participate in society. It boils down to countless everyday things that people take for granted when their identities are not contested. Being able to use public washrooms without risking confrontation or violence. Accessing information on reproductive health that normalizes your body and healthcare experiences. Not being asked to explain where your partner is at prenatal appointments when they are in the exam room with you. Being able to find pregnancy attire that aligns with your usual style.

Trans and queer people need to call for visibility and wear pink to get noticed so that we can lead normal lives.

As birth workers, here are some things we can do to help queer and trans folks feel seen in the reproductive and perinatal wellness sphere:

  • State explicitly in your promotional materials that you welcome and affirm queer and trans people
  • Use gender-neutral language in your promotional materials and handouts
  • Have open conversations with clients about their preferred pronouns and terms for their parenting roles and body parts.
  • Become familiar with resources in your community that support queer and trans families so you can make great referrals.
  • Educate yourself on health inequities faced by queer and trans birthers
  • Challenge queer and transphobia in yourself and others

You can find out more about Trans VisibilityVisibilty Day here

You can find out more about International Day of Pink here

 

Keira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][/vc_row]

Categories
Anti-Oppression community connection Equity intersectionality LGBTQ2S+ Newsletters pride understanding bias vulnerabiliity

Unlearning the Nuclear Family

[vc_row][vc_column][vc_column_text css=”.vc_custom_1685714926487{margin-bottom: 0px !important;}”]When I was a kid in the 80s, the family sitcom dominated television. From the Huxtables to the Keatons, to the Seavers, it was always Mom, Dad, and 2.5 kids. By then, the nuclear family had become the norm, so usually, both Mom and Dad worked outside the home. 

I always knew I wanted to be a mom someday. Even though my family didn’t look like the ones I saw on TV (I was raised by an Aunt and a Grandma), somehow it never occurred to me that the family I made someday would look different from the ones I saw on TV. I always pictured Daddy, babies, and me.

As I got older and came out as bisexual, my visions of future family life expanded to include the possibility of parenting with a “Daddy” or another “Mommy”, but I was still locked into a really nuclear understanding of what “families” looked like. 

Now my life has taught me a lot better. I do parent my only child with my wife, but welcoming Baby into our family made so much more than three. Our chosen family comprised of friends and partners from our queer and polyamorous communities has always been a huge part of our parenting journey.

We know many beautiful families configured in ways that transcend a couple with kids. We know quartets of a lesbian couple and a gay couple who have chosen to co-parent. We know gay and lesbian besties who have chosen to co-parent with their respective biological and chosen families behind them. We know lesbian couples with a known sperm donor who is deeply involved in their child’s life. There are triads or “thrupples” (a partnership involving 3 adults) who choose to raise families. This could look like a mom having a baby with each of her two male partners, or two women each having a baby with their male partner or any other number of ways of creating a family.

The reality is that Queer and Trans Culture isn’t just about having a life partner who was assigned the same sex as you at birth. Our cultural norms are forged from a history where the most conventional, nuclear way that we could have a family was still socially unacceptable. Many of us and our queer elders were rejected by our biological families for being honest about who we are. As a result, our community has been resourceful and resilient in carving out new ways of defining “family” and building family units that allow us to be whole. We create our own villages that know who we are, where we’ve been, and where we’re going to support us while we child rear and do this thing called life.

5 was a vital turning point for queer and trans families. It made the relationship to the child the focus of parental rights, rather than biology. The law also makes it possible for more than two people to be the legal parents of a child. This legal change was extremely important, but it’s only a fraction of the needed social change.

We must unlearn the idea that “parent+parent+kid(s)=family”. There are infinite equations that can add up to a family. As professional support people, we can embrace the expectation that clients seeking our help could come in ones, twos, or more, reflecting any mix of gender identities. 

We can also expect that folks living outside the parental binary are seeking our support specifically because they can expect that other parts of the health and social service systems don’t expect them, and might be hostile toward anything or anyone that challenges their expectations. We can create an unconditional blanket of compassion and support around all the beautiful shapes and sizes that families come in. That blanket is also a shield against fear and hate that preserves the sacredness of the parenting journey for all people.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_padding_divider][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1686178152124{margin-bottom: 0px !important;}”]

Keira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][/vc_row]

Categories
Anti-Oppression intersectionality LGBTQ2S+ pride Uncategorised vulnerabiliity

Why Representation Matters.

[vc_row][vc_column][vc_single_image image=”502714″ img_size=”full” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][mk_padding_divider][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1685976157863{margin-bottom: 0px !important;}”]As Pride month comes to a start, I decided to write a more personal piece for the Doula Canada blog. As many queer people know, the process of coming out isn’t linear nor a one time deal. Queer people often come out over and over, in every day interactions. We decide whether or not its safe to come out, whether or not it will have repercussions professionally, socially, and within our family circles. Pride comes with a lot of baggage. Working at a feminist vocational school, that celebrates diversity and inclusion, I know that writing this is a safe space. 

You see, I’m freshly out. I’ve been “out” as pansexual for about five years, but being “conceptually queer” and “actively queer” feel very different. Not that pansexuals do not struggle, we do, but we have one of those “border” identities where we can experience privilege and oppression at the same time, i.e. “passing”. Being able to pansexual while being in opposite sex relationships had a sense of “safety” in it. I could identify as queer, but also feel accepted and included by following compulsory heterosexuality. 

What is that you ask? Compulsory heterosexuality is the concept that society favors those who act in heterosexual ways. Our social norms favor heterosexuality, and it is assumed to be the default. You see this when someone asks you if you have a spouse of the opposite sex. When teachers can speak about their partners freely (as long as they are straight) and we assume things about strangers we do not know. Being conceptually queer, but passing as “actively straight” kept me safe. I didn’t have to have uncomfortable conversations, debate whether someone would be accepting of my partner, or wonder if it would be a deal breaker for a job. Until one day, passing didn’t work for me.

I’m 28 years old from a rural area in Northeastern Ontario. I went to a Catholic school where bringing a partner of the same sex to prom was forbidden, and we were told our “lifestyles” were unnatural and against God. I came from an area where queer people were (visibly) few and far between, and if they were outed they were ostracized for being “predators” or other horrendous, homophobic things. At one point, I thought I was queer when I was about 14 years old. A school counselor told me that all girls feel that way at some point, and I believed her. As I grew up, I thought I was emotionally bankrupt to all my boyfriends, that perhaps I was asexual, or traumatized, and that one day I would marry a husband. Asexuality and trauma are valid, but for me, it was a mask that seemed “more appropriate or acceptable” than the thought that I may be attracted to women. I didn’t realize that most women don’t see finding a husband as a begrudging task on a to-do list. This was compounded by the “ball and chain” rhetoric of a heteronormative and often misogynist society. Dating, sex, and marriage is supposed to be disappointing if you are a woman with a man (we’re often told).  It was easier for me to believe I may be asexual or traumatized than to think I may one day marry a woman. This is when I realized, I may not be attracted to men at all. But I didn’t know what that would look like.

Representation matters, because I had none. 

I was 20 before I saw a lesbian in a professional role, that wasn’t actively trying to hide her identity from the institution she was employed from. She was my Women’s Studies 1000 professor, and I thought about how brave that was. I didn’t realize that queer women could be out in positions of power without punishment.

I was 24 before I realized that you could be queer without ostracization in a bigger city. I was surrounded by queer friends who were living their joyful lives, loving their partners, and living (mostly) without harassment.

I was 26 before I met my first queer couple with children. I was downtown Toronto and finally seeing lesbian and gay couples living loud and proud, and simple and boring just like any other couples. I had never seen pregnancy and childrearing in queer couples, and had always tied my dream of having kids with being in a heterosexual relationship. Representation changed this for me.

How does this relate to doula work? Easy. If you’re a queer doula, you are actively showing the world that queer people belong in the doula space. If you’re creating inclusive advertising for trans and queer people, you are telling them you see them, and they belong in the reproductive health discussion. When you use a trans person’s pronouns, you are validating their experience and showing them you respect their identity. When you learn about surrogacy, IVF, and adoption support, you are creating more services for queer people to access.

Representation matters because it shows queer youth, and queer adults that their experiences are normal, and can be expansive and joyful. It shows others the possibilities within being queer. It shows us our dreams can exist in a comphet society, and that we don’t have to give up a part of ourselves to be happy. So this pride, when you hear someone say “Why do they have to be so LOUD about it?” tell them its for every queer person who is forced to live quietly, and is silently listening.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_separator color=”violet”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1685976337654{margin-bottom: 0px !important;}”]

Kayt (she/her) is an Anishnaabe kwe from Bonnechere Algonquin territory and the owner of Sweetgrass Solace Wholistic Support. Her post-secondary education includes a Bachelor of Social Work and Bachelor of the Arts in Indigenous Studies from Trent University (2021). She is also a certified hatha yoga teacher and a certifying birth and postpartum Doula.[/vc_column_text][/vc_column][/vc_row]

Categories
About Us Anti-Oppression Anti-racism work birth Business collaboration community connection decolonization Equity indigenous doula intersectionality Labour Doula LGBTQ2S+ Postpartum Doula research Trauma understanding bias

Doula Canada Presents: Anti-O Bingo

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Aaniin Doulas!

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This month we are introducing a new EDI initiative, and we want our students and alumni to play! Introducing…. Anti-O Bingo!
You’ve given your input, and we’re listening. Through our Truth and Reconciliation Action Plan, and our EDI surveys, we have identified anti-oppression and cultural training as one of the many areas Doula Canada doulas are interested in pursuing.

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How to play:
1. Click HERE to download your free Anti-O Bingo Card
2. Attend an event from each category
3. At each event, ask your facilitator for your custom .jpeg stamp. Paste it into a doc! (Remember to save it!). If you are attending a livestream (Just Birth, Fireside Chat, etc), please submit a paragraph on what you learned to kayt@doulatraining.ca
4. When you have all 8 stamps, please submit your doc to kayt@doulatraining.ca for your Anti-Oppression in Doula Care 101 Certificate and a ballot to win an $100 Etsy Gift Card.

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You have until December 31, 2023. Good Luck!

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Chi Miigwetch! Nia:wen!
Kayt Ward and Keira Grant, EDI Leads

[/vc_column_text][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”494571″ img_size=”full”][/vc_column][/vc_row][vc_row][vc_column][mk_button corner_style=”rounded” size=”large” url=”https://stefanie-techops.wisdmlabs.net/wp-content/uploads/2023/04/edi-bingo.pdf” align=”center”]Get Your Anti-O Bingo Card here![/mk_button][/vc_column][/vc_row]

Categories
Anti-racism work birth Canada community connection decolonization Equity Health Care intersectionality pregnancy Trauma understanding bias

Why Black Futures Begin with Birth

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Why Black Futures Begin with Birth

Written by Keira Grant  – DTC EDI Lead for Racialized Communities

February is widely known as Black History Month. This term has rubbed me the wrong way since I was a kid, but it took me a while to put my finger on why. The reference to “history” is full of loaded assumptions that are highly convenient to colorblind multiculturalism. It suggests that racism toward Black people is something that happened a long time ago, maybe in a faraway place. Then slavery ended and then there was Black excellence.

Of course, there have always been excellent Black people, but that’s not really how the story goes. The beliefs that made slavery possible for centuries are part of the fabric of society. Even when we are excellent by eurocentric, capitalistic standards, it could still go the way it went for Tyre Nichols.

The violence that brutally ended the life of Tyre and so many others like him flows through all social institutions, not just policing. In countries such as the United States and the United Kingdom where race-based health data is collected, these data show that Black birthers are anywhere from 3 to 4 times more likely to die in childbirth than their white counterparts. Our babies are also at a significantly increased risk of death. This holds true, independent of education and socioeconomic status. The birth stories of celebrities like Beyoncé Knowles, Serena Williams, and Tatiana Ali, (whose story we’ll be discussing at March’s Equity Watch Party), bring these statistics to life.

At this time, many players in the Canadian healthcare system are calling for the collection of disaggregated race-based data. In the US, the collection of these data, and the resultant evidence of disparities has led to increased funding for programs that improve Black maternal health, including a proliferation of programs for accessing a Black doula. It has also supported requirements that health professionals receive training in implicit bias.

It’s been widely reported in the news that Tyre Nichols called out for his mom during the brutal attack that ended his life. Every Black person who dies as a result of structural violence is someone’s baby. When systemic disrespect and harm toward Black birthers and babies is normalized, rationalized, and justified it is the start of a pattern that impacts Black people across the lifespan. Emerging research is actually demonstrating that racial stress accelerates the aging process of Black women.

Creating a circle of love and support around Black birthers and their babies that is honest about what we are up against, and that celebrates our lives and well-being can have a profound impact on how someone’s life starts. It can affect how their life continues by showing them and their families that it is possible to create spaces where Black people are affirmed and nourished.

We talk about equity, diversity, and inclusion in this work all the time. During February, we have additional opportunities for our members to learn and engage in dialog about anti-Black racism and racial health equity in perinatal care. We are using the language Black Futures Month, “a visionary, forward-looking spin on celebrations of Blackness in February”.

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Categories
Anti-racism work birth Health Care intersectionality Labour Doula LGBTQ2S+ Postpartum Doula Trauma Uncategorised understanding bias vulnerabiliity

Advocacy at Doula Canada

[vc_row][vc_column][vc_column_text css=”.vc_custom_1669384798061{margin-bottom: 0px !important;}”]Doulas support birthers, babies, and family members during an intimate and emotionally charged experience that often involves many medical twists and turns along the way. For many doula clients, pregnancy and childbirth are among the most complicated experiences with our healthcare system they will have ever had to navigate. We know that birthers need to feel in control of what happens to their bodies and to be making informed choices about their care to create a positive experience and avoid trauma. 

Doulas can change a person’s healthcare experience for the better by supporting their bodily autonomy and informed decision-making. Additionally, we are well placed to notice systemic issues that impact our clients again and again, and to use our knowledge to encourage and support changes.

Learning to engage in this type of advocacy within the scope of the doula’s role, so that our efforts are helpful, is an important aspect of our learning and professional development. To support our students and alumni, Doula Canada has developed an advocacy framework that defines advocacy in the context of doula practice and describes approaches to individual advocacy that are aligned with respect for client autonomy. 

Our framework identifies three categories of advocacy that doulas engage in: systemic advocacy, self-advocacy promotion, and individual advocacy. 

Systemic advocacy is any effort to change, remove, or add a policy or process that affects the lives of birthers, families, babies, or doulas. Examples include lobbying your elected federal representative to change the birth evacuation policy or amplifying social media campaigns that raise awareness regarding perinatal mental illness.

While we don’t usually think of it as such, our work with clients to support them to know the evidence regarding their perinatal circumstances, and ask the right questions of their healthcare providers is a form of advocacy. We encourage them to use their voice and make their conversations more effective because they are armed with information.

Sometimes, especially in the birth room, it might be necessary to advocate for the client in more direct ways. It is important that this individual advocacy does not manifest as speaking for or over the client, or in a manner that could worsen their care or medical situation.

A 2020 paper by S.S. Yam based on interviews with doulas identified three types of tactics that doulas use to advocate for their clients during labour and delivery. She calls these “soft-advocacy” techniques because they differ from what we usually think of as advocacy. Staff and instructors at Doula Canada agreed they used these strategies and had lots of guidance to offer on exactly how to use them. Their guidance was used to develop the advocacy framework. 

The three tactics identified by Yam are 1) creating deliberative space, 2) cultural and knowledge brokering, and 3) physical touch and spatial maneuvers. 

Creating deliberative space refers to strategies that give the client more time to ask questions and make decisions. One example of how doulas do this is by noticing that care that deviates from their preferences is about to happen and bringing it to the client’s attention, prompting them to ask about the intervention that is about to happen.

Cultural and knowledge brokering refer to the tactics doulas use to make sure the client understands medical jargon or cultural norms. This could involve paying close attention to the information provided by the medical team, observing how well this is understood by the client, and repeating the information in language that the client uses and understands.

Physical touch and spatial maneuvering refers to the ways we use our bodies and physical contact with the client to advocate for their needs. Examples include using our bodies to conceal the client from view, modeling consent by asking permission each time we touch the client, and using our presence to back up the client during interactions. 

The complete framework is linked below. It offers more detail on the three types of advocacy and the soft-advocacy strategies. It illustrates these concepts using case studies based on staff and instructor experiences. 

In 2023, Doula Canada will continue its work to support advocacy among its members by developing an advocacy toolkit from the framework and launching an advocacy working group for students and alumni. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_button corner_style=”rounded” size=”large” url=”https://stefanie-techops.wisdmlabs.net/wp-content/uploads/2022/11/advocacy-framework-paper.pdf” align=”center”]Click here to view the full Advocacy Framework document[/mk_button][/vc_column][/vc_row]

Categories
Anti-racism work birth Business Canada Childbirth Educator collaboration community connection Equity fear intersectionality Postpartum Doula pregnancy reducing stigma research shame Trauma understanding bias vulnerabiliity

Recognizing Asian Heritage Month and Jewish Heritage Month

[vc_row][vc_column][vc_column_text css=”.vc_custom_1653215730289{margin-bottom: 0px !important;}”]May is Asian Heritage Month and Jewish Heritage Month. It’s a great opportunity to reflect on what we mean by “heritage” regarding the history of these two communities in “multicultural” Canada, and what this means for creating cultural safety in birth work.

I’ve lived in the GTA my whole life. Here, a “heritage festival” typically amounts to a street party with food, live music and dance, and other culture-specific entertainment. I am actually a great lover of a good street fair. The food and performances are usually lit. I have also learned a lot about Jewish and Asian history and culture at events like the Ashkenaz Music Festival and Taste of Asia. I also understand that many communities are not fortunate enough to have this level of exposure to culture and diversity. But these cultural displays are not only far from telling the whole story of the “heritage” of Asian and Jewish people in Canada, but they also contribute to “false peace” – the illusion that multiculturalism is working out, that we are all getting along, and that we are all equal.

In truth, there is anti-Asian racism and anti-Semitism at the core of Canada’s heritage. Those of us who remember “Heritage Minutes” from the 1980s and 90s may know about the lethal exploitation of Chinese migrant workers that occurred in the 19th century to support the construction of the trans-Canada railroad. There are many other examples, including the head tax, and internment camps during WWII. 

Anti-Semitism is equally a part of the fabric of Canada’s history. Wide-spread belief in a Jewish conspiracy to achieve global economic domination that originated in Europe and spread to North America made Jewish Canadians an easy scapegoat during the great depression. Additionally, to limit the economic advancement of Jewish immigrants in the early 20th century, Canadian universities implemented quotas that restricted the number of Jewish applicants who could be admitted to the school.

It’s easy to hear these stories and think “this has nothing to do with me”, “this is ancient history”, “I didn’t do these things”, and “let’s focus on the positive and how far we’ve come”. While these sentiments are understandable, the reality is that the present arises from the past. These uglier parts of our heritage are directly related to more recent attacks on synagogues and the hate crimes experienced by Asian Canadians during the pandemic. 

Moreover, this heritage underpins the modern assumptions that manifest more subtly as microaggressions that affect the day-to-day navigation of society and impact the long-term mental and physical health of equity-seeking people. Some of these stereotypes may seem harmless or even positive. But in reality, they fuel the construction of whiteness as the social norm, put people in boxes, and create false impressions regarding people’s realities.

As birth workers, we can create cultural safety regarding the beautiful and the traumatic aspects of each client’s heritage. We can create space for them to share whether they have any cultural or religious traditions that they would like to honour. And we can also be mindful of things like how common stereotypes about Asian women may influence provider perceptions of client autonomy. Or how the intergenerational trauma of Holocaust survivors may impact pain management. There are a number of ways that our identities can impact our pregnancy and parenting journey. Shining a light on the good, the bad, and the ugly of our heritage sets us up to ask the right questions and facilitate the needed conversations with all of our clients.[/vc_column_text][/vc_column][/vc_row]