Helpful Frameworks for Understanding Recommendations

Based on the suitable recommended practices for supporting 2STNBGNC+ demographics, this strategy brings together two frameworks: one based on addressing the four pillars of community health and another based on harm prevention and reduction.

The four pillars of community health approach is being implemented by some 2SLGBTQIA+ non-profit organizations in Canada. For example, HIM: Health Initiative for Men is a non-profit organization based in Vancouver BC that supports male-identifying queer individuals. HIM uses the four-segment community health strategy based on four pillars of health to respond to pressing issues under each pillar:

• Sexual Health - includes free and anonymous HIV and STI testing, PEP - Post-Exposure Prophylaxis, PrEP - Pre-Exposure Prophylaxis, STI treatment, Doxi PEP and PrEP (STI Prophylaxis), and vaccinations (monkey pox, human papillomavirus, etc.). All medical staff are trans-aware and trained to understand public health issues facing by the 2SLGBTQIA+ and 2STNBGNC+ communities.
• Mental Health - includes free and flexible-scale counselling and coaching sessions provided by queer and trans therapists, and peer support groups for members of the 2STNBGNC+ community.
• Physical health - includes activities to improve physical health such as running, rowing and yoga sessions.
• Social Health - includes regular group gatherings for various parts of the 2SLGBTQIA+ community, such as racialized community members, 55+ community members, new immigrants, and more; it also includes activity-based clubs and special events.^[1]

The history of the organization determined the choice of “pillars”: HIM was founded in 2008 in Vancouver BC as a grassroots initiative to support HIV prevention. The HIV crisis of the 1980s drastically and disproportionately affected gay men and transgender people, exposing inequalities in access to health care and the social stigma associated with, in today's terms, sexual orientation, gender diversity and gender expression. Therefore, HIV prevention, education and support programs are at the heart of the mandate of many organizations that support 2SLGBTQIA+ and 2STNBGNC+ groups, including HIM.^[2] It is important to recognize the importance of HIV prevention programs, which catalyzed advocacy and public education for many organizations.^[3] Later, many nonprofits expanded their work beyond the "sexual health pillar" to include other segments of 2SLGBTQIA+ wellness, such as mental, physical, and social health. Understanding how these pillars are interrelated allows for a better understanding of the invisible barriers and determinants of harm faced by the various community groups under the 2SLGBTQIA+ umbrella and supports the development of effective policies, support programs, and advocacy.

Looking at the pillars from a safety perspective, this approach could be adapted to the data collected during the consultation with 2STNBGNC+ campus community members, who highlighted the importance of:

• Physical Safety (Physical Health Pillar).
• Emotional safety (Mental Health pillar).
• Social safety, trustworthiness and transparency with campus leadership, collaboration across units, cultural responsiveness, and addressing marginalization and equity (Social Health Pillar).

The issues related to sexual health, HIV and STI education, prevention and treatment implicitly emerged as a general community necessity that needs to be addressed along with other issues that impact community well-being. 

The harm prevention and reduction framework approaches 2STNBGNC+ wellbeing from the perspective of preventing and responding to harm and crisis. This approach focuses on policies and procedures rather than providing services. Given the rise of anti-gender, anti-trans and anti-2STNBGNC+ laws and policies around the world, many nonprofit initiatives, human rights and civil society foundations are choosing the harm prevention and reduction approach for its strategic planning capacity. This approach allows for the consideration of anticipated harms and the development of relevant responses, including preparedness, hard reduction, and recovery programs. For example, in response to a new wave of anti-LGBT movements in Central and Eastern Europe, the Caucasus, and Central and North Asia, Dalans Fund launched a new funding line based on crisis prevention and response.^[1] It includes four components:

• Crisis Prevention - includes supporting activists and community organizers to identify and draw attention to a potential crisis, assess risks, and develop strategies to address them.
• Crisis Preparedness - includes timely and effective awareness and response to emerging crises by developing and providing functioning infrastructure and response protocols.
• Crisis Response - includes supporting a variety of interrelated efforts to assist those affected by the crises, human rights awareness, emergency fund resources, medium and long-term movement-led strategies and responses.
• Crisis Recovery - includes addressing the impacts of the crisis and moving forward towards stabilization and recovery, it includes community rebuilding efforts, supporting mental health and counseling programs, economic crisis programs, and regenerating community-based activism.^[2]

This perspective is community-aware and responsive. With appropriate tailoring, it works well with the emergency planning policies and procedures that are a critical part of human resource management and occupational health and safety (OH&S) initiatives.

It is important to consider the semantic and operational differences between working with emergency issues in OH&S and community-based safety and harm reduction.  In OH&S emergency is understood as a “sudden and generally unexpected occurrence or set of circumstances demanding immediate action.”^[3] While in initiatives supporting 2STNBGNC+ community, emergency typically does not refer to a single event, but rather to pressing challenges that require immediate action to raise awareness and mitigate physical and gender-based violence against 2STNBGNC+ community, homophobia and transphobia in the workplace, inappropriate jokes and microaggressions, and systemic exclusion from accessing social services.^[4] In other words, in community support, a harm prevention and reduction measure addresses a series of events that target and oppress a particular group. 

For example, common emergency planning procedures in OH&S include:

• Emergency preparedness protocols allow you to anticipate and implement actions that will allow you to respond quickly and efficiently to an emergency.^[5]
• Emergency plan that includes pre-contact, contact, and post-contact phases, including:
  • Pre-contact stage - assessing hazards and planning possible responses,
  • Contact Stage - evacuation procedures, medical care for casualties, and ensuring emergency response, and
  • Post-contact stage - dealing with the emotional trauma caused by an emergency and implementing an orderly return to work.^[6]

Considering the 2STNBGNC+ community-informed and responsive approaches to the Trans & Non-binary Equity Strategy aligns existing initiatives with new actions, while recognising that existing supports and services may need to be strengthened or enhanced to effectively meet the needs of 2STNBGNC+ students and employees. Therefore, the outcomes of the 2STNBGNC+ Knowledge Gathering and Sharing Project are grouped around the pillars of community wellbeing.