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Dal Health researcher championing LGBTQ+ health equity
Dr. Jacqueline Gahagan (School of Health and Human Performance) started her research career in Ottawa in the 1980s, doing work on HIV. One day, she went to the Gays of Ottawa Centre and saw homophobic and AIDS-related graffiti on the building. Since then, Dr. Gahagan’s undergraduate (Anthropology and Sociology - Carleton University), Masters (Sociology - University of Windsor) and PhD (Medical Sociology – Wayne State University) were all related to HIV and health equity.
“The hateful, visceral reaction to gay people comes from a place of misinformation. Health equity is a way of correcting that information, getting people facts,” she says. “I’m from that queer community so it’s near and dear to my heart – that hateful reaction to HIV hit home to gay people.”
Now, Dr. Gahagan’s research profile has expanded to include many health equity issues for LGBTQ+ people and includes housing and end-of-life care for seniors, access to health care, and plasma donations for gay, bisexual and trans men.
Dr. Gahagan says thanks to anti-viral therapy, a lot of HIV-positive people have survived, but the stigma of those living with HIV is still present. Jacquie is co-lead of national HIV Stigma project in her role as co-Director of the Atlantic Interdisciplinary Research Network on the Social and Behavioural Aspects of HIV and Hep C.
‘Where do you go when you’re old and gay?’
Dr. Gahagan is currently working on a Social Sciences and Humanities Research Council (SSHRC) funded project that looks at LGBTQ+ seniors and housing – an area she says has not been documented enough in this country in terms of data collection or research.
“There are older queer people who have spent decades fighting violence and hate. They fought for gay rights and now in some circumstances they have to go back in the closest,” she says.
“Where do you go when you’re old and gay? How do we make sure there are safe and affirming resources, including housing?”
Dr. Gahagan worked with her team to address this knowledge gap. They did a scoping review of international literature for housing for older LGBTQ+ people, conducted an online survey of 1,000 people, and held focus groups in five cities; Halifax, Ottawa, Nanaimo, Winnipeg and Calgary.
From those surveys and focus groups, they heard that senior LGBTQ+ people are particularly afraid of going into long term care facilities. Some people had experienced a lifetime of harassment and discrimination due to their sexual orientation and/or gender identity, now there was the fear they would face precarious situations or end up homeless.
Collecting better data
A key policy change is the need to collect better national data on the housing issues facing LGBTQ+ Canadians, Dr. Gahagan explains. She says current policies in long term care facilities are not to ask for sexual identity, so people remain anonymous. LGBTQ+ seniors often call facilities and ask how gay-friendly they are, and the answer is, ‘we don’t have any of those people here’, when the caller knew that they in fact did.
“One housing provider said we don’t feel comfortable asking that question, so I would suggest they change their policy so they can ask people to safely volunteer to provide that information.”
Dr. Gahagan says there is also a need to train staff and residents about LGBTQ+ history – why it’s important to residents and find ways to enforce a zero-tolerance policy of discrimination.
“One gentleman who participated in our study lives in senior living. He’s afraid to leave his apartment, he is afraid people know he is gay and HIV positive and he’s worried about going into the hallway because he thinks he will be harassed or beaten up.”
The next step in this research is to update the original online housing survey and add questions about COVID-19 and how the pandemic has affected their housing experience. In addition, Dr. Gahagan has founded a housing society to move the key findings into action in addressing the unique housing needs of older LGBTQ+ Nova Scotians.
LGBT Senior Archive
Dr. Gahagan is also creating the Nova Scotia LGBT senior archive which will be a permanent collection housed at Dalhousie’s Killam Library, with moving exhibits in the Halifax public libraries.
She says the project, funded by the Nova Scotia Department of Seniors, focuses on the baby boomer generation who advanced the rights of LGBTQ+ Canadians, whose stories and contributions risk being lost if not preserved.
“It’s really important. I’ve been gay my whole life and I’ve seen people who have pushed the envelope. I was involved in the same sex marriage campaign in Ontario, pushing these basic human rights that have been blocked forever. That generation that survived HIV, the bathhouse raids, the purge from employment in the civil service. I would have loved access to this information when I was in in university.”
Dr. Gahagan says this collection will include photos, newsletters, videos, buttons, banners, etc. and will be a huge resource to students, researchers and the public.
“Creating this permanent collection thrills me to no end. If I had pitched it 10 years ago, I don’t know if it would have happened. There’s a great and urgent need to do this sooner than later.”
Dr. Gahagan is also working on a two-year study with Canada Blood Services to look at changing the donor screening protocol so that diverse gay, bisexual and trans men can donate plasma.
She is also doing research on end-of-life conversations for LGBTQ+ seniors – talking about their preparedness and the availability of queer-friendly resources such as lawyers and funeral home directors.
Another project is Cancer's Margins looking at breast and gynecological cancers among lesbian, bisexual and transgender Canadians to understand their cancer care journeys.
In addition, Dr. Gahagan is working with the Nova Scotia Authority as an Affiliate Scientist to understand why LGBTQ+ people in Nova Scotia aren’t accessing health care and why they have worse health outcomes, and what policies can be put in place to make health care more inclusive and accessible.
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