About our research
The REAFFIRM Collaborative is committed to promoting 2S/LGBTQ+ (Two-Spirit, as well as lesbian, gay, bisexual, trans, queer, and other sexual and gender minority people) health equity through research. Using a broad range of approaches – including epidemiology, qualitative research, and mixed methods – to explore factors contributing to health inequities and to identify strategies for improving health among 2S/LGBTQ+ populations. We work closely with a range of collaborators and stakeholders to ensure that our research is directly applicable to equity-focused policy, practice, and action.
Ongoing projects
Delivery of 2S/LGBTQ+ affirming sex education in Canada
Comprehensive sex education that is explicitly affirming of 2S/LGBTQ+ identities and experiences is associated with a range of improved health and social outcomes. However, there are persistent gaps in access to affirming sex education; existing evidence suggests that teachers often lack the tools, training, and resources to deliver this content. This study explores the experiences of teachers when teaching sex education, including: Training and resource needs when delivering sex education; Approaches used to deliver sex education content, particularly 2S/LGBTQ+ affirming sex education; Supports and constraints experienced; Strategies and approaches used to respond to and mitigate the effects of constraints faced (e.g., community and parent push-back). The current project is informed by a 2021 pilot project. Check out our most recent publication to learn more!
Rainbow Canada: Exploring the 2S/LGBTQ+ policy paradox
In recent decades, Canada has enacted a series of legislative and policy protections to support the health, wellbeing, and safety of 2S/LGBTQ+ people. However, we continue to see a large gap in health status between 2S/LGBTQ+ people and cisgender-heterosexual (cishet) people. Together with our partners at Egale Canada, we created Rainbow Canada to help us understand this paradox. The Rainbow Canada website centralizes information about federal, provincial, and territorial laws and policies protecting the rights and well-being of 2S/LGBTQ+. It’s meant as a tool for understanding, advocating for, and creating public policy to advance 2S/LGBTQ+ rights. Building on this, we want to learn what else is needed to better understand and redress these inequities. We are currently gathering feedback to identify additional domains to be added to the index in order to more accurately represent inter-provincial/territorial variations in structural stigma. Learn more.
Reproductive Health of Sexual Minority Women in Canada
Using data from the Canadian Community Health Survey, we explored reproductive health and intentions among sexual minority women in Canada. The goal of this study is to better understand pregnancy intentions, contraceptive use patterns, and reproductive health outcomes among SMW.
MindMapBC
MindMapBC is a 2S/LGBTQ+ mental health service finder. It features mental health and related 2S/LGBTQ+ supports (e.g., peer support groups, social groups, resources) from across BC. Website visitors can filter services to find supports that are affirming, accessible, and free or low cost.
Together with our community collaborators (Health Initiative for Men, The Community-Based Research Centre, The Roundtable, and many more) and advisory group members we worked to refine, expand, and promote the site. In 2023, we conducted a survey and series of qualitative interviews to help us better understand the mental health needs and priorities of people seeking support. Read our community report to learn more. We are thrilled to announce that in 2024, our partners at Qmunity took over MindMapBC, to bring the site to even more communities across the province!
The UnACoRN Study
The UnACoRN Study (Understanding Affirming Communities, Relationships, and Networks) is a survey of youth ages 15-29, living in Canda or the US. The survey aims to better understand the range of environments in which youth have their sexual and gender identities supported or threatened. We conducted the first survey in 2022, with a follow-up survey in 2023. Learn more about the survey!
Ending Conversion Practices
Our research seeks to understand how minority stress, stigma, and other social and environmental influences shape patterns of mental health outcomes. In particular, our research explores conversion therapy practices and other sexual orientation and gender identity and expression change efforts (SOGIECE), which are associated with a range of adverse health and social outcomes. Using a broad conceptualization of SOGIECE practices, we aim to understand the various avenues and environments in which 2S/LGBTQ+ people in Canada experience SOGIECE. For example, current research explores the role of 2S/LGBTQ+ – affirming, anti-oppressive sex education in promoting well-being. Research findings have helped to inform the development of legislative action to end conversion therapy practices in Canada and to identify opportunities to support survivors of conversion therapy.
Learn more:
Other Resources:
- Addressing Sexual Health Anxiety
- Salway T, Juwono S†, Klassen B, Ferlatte O, Ablona A, Pruden H, Morgan J, Kwag M, Card K, Knight R, Lachowsky NJ. Experiences with sexual orientation and gender identity conversion therapy practices among sexual minority men in Canada, 2019–2020.
- Salway T, Gesink D, Ferlatte O, Rich AJ, Rhodes AE, Brennan DJ, Gilbert M. Age, period, and cohort patterns in the epidemiology of suicide attempts among sexual minorities in the United States and Canada: detection of a second peak in middle adulthood. Soc Psychiatry Psychiatr Epidemiol 2021;56(2):283-294.
- Goodyear T, Kinitz DJ, Dromer E, Gesink D, Ferlatte O, Knight R, Salway T. “They want you to kill your inner queer but somehow leave the human alive”: Delineating the impacts of sexual orientation and gender identity and expression change efforts. J Sex Res 2021.
- Salway T, Butt ZA, Wong S, Abdia Y, Balshaw R, Rich AJ, Ablona A, Wong J, Grennan T, Yu A, Alvarez M, Rossi C, Gilbert M, Krajden M, Janjua NZ. A computable phenotype model for classification of men who have sex with men within a large linked database of laboratory, surveillance, and administrative healthcare records. Front Digit Health 2020.
- Salway T, Ferlatte O, Gesink D, Lachowsky NJ. Prevalence of exposure to sexual orientation change efforts and associated sociodemographic characteristics and psychosocial health outcomes among Canadian sexual minority men. Can J Psychiatry 2020;65(7): 502-509.
- Black S, Salway T, Dove N, Shoveller J, Gilbert M. From silos to buckets: a qualitative study of how sexual health clinics address their clients’ mental health needs. Can J Public Health 2020; 111(2):220-228.
- Salway T, Plöderl M, Liu J, Gustafson P. Effects of multiple forms of information bias on estimated prevalence of suicide attempts by sexual orientation: An application of a Bayesian misclassification correction method to data from a systematic review. Am J Epidemiol 2019;188(1):239-249.
- Salway T, Ross LE, Fehr CP, Burley J, Asadi S, Hawkins B, Tarasoff LA. A systematic review and meta-analysis of disparities in the prevalence of suicide ideation and attempt among bisexual populations. Arch Sex Behav 2019;48(1):89-111.
- Salway T, Ferlatte O, Shoveller J, Purdie A, Grennan T, Tan DHS, Consolacion T, Rich A, Dove N, Samji H, Scott K, Blackwell E, Mirau D, Holgerson N, Wong J, Gilbert M. The need and desire for mental health and substance use-related services among clients of publicly funded sexually transmitted infection clinics in Vancouver, Canada. J Public Health Manag Pract 2019;25(3):E1-E10.
Blog posts
- Watt S. Addressing sexual health-related anxiety among sexual health service users.
- Young J, Kennedy A, Vitkin N. LGBTQ2 Communities and SFU Students Come Together to Improve Access to Mental Health Services 2021.
- Salway T. Promoting LGBTQ2 mental health through an end to conversion therapy: The role of public health. National Collaborating Centre for Determinants of Health 2020.
- Salway T. New data suggests conversion therapy practices are still common across Canada. CTV News. 2021 June 5.
- Salway T. To end conversion therapy, we must understand what it actually means. The Globe & Mail. 2020 May 26.
- Bowness G. Surviving conversion therapy: Matt Ashcroft’s story illustrates why a federal ban on conversion therapy is vitally important. Xtra. 2020 March 23.
- Ryan B. Pressure to keep up: status imbalance a major factor in stress in gay men. The Guardian. 2020 February 29.
- Crawford T. Thousands of Canadians still experience conversion therapy despite bans: Report. The Province. 2020 February 24.
- Sharpe B. How universal health care fails queer communities. The Walrus. 2020 February 11.
- Hobbes M. It’s not getting better for queer kids. Huffington Post. 2020 February 11.
- Hurren K. Everything you need to know about conversion therapy in Canada. Xtra. 2020 February 5.
- Faulder L. Conversion therapy: controversy swirls as definitions and dimensions remain elusive. Edmonton Journal. 2019 August 26.
