Pride Month: An Interview With A CAMH Social Worker

Trigger Warning: topics of suicide, addiction, transphobia, homophobia, biphobia, stigma

Tye Kenny is a registered Social Worker (MSW) who currently works as a Clinical Social Worker at Rainbow Addiction Services, as well as New Beginnings (refugee clinic) at The Centre for Addiction and Mental Health (CAMH). Tye’s formal studies include a Bachelor’s and Master’s degree in Social Work from York University (Toronto, ON).

I was fortunate enough to sit down with Tye (via Zoom) and discuss some of his work at Rainbow Addiction Services. This particular program at CAMH is by self-referral meaning, only folks who want to be there attend the meetings. Rainbow Addiction Services is exclusively for queer-identifying folks. Tye explained that while there are indeed group meetings, he is also in charge of doing individual check-ins which he gauges on a case-by-case basis.

Tye fully acknowledges the responsibility of the Social Work field to update its previously discriminatory policies. He is completely aware of Social Workers’ negative impact on Indigenous families throughout Canada’s history and is adamant about reinventing the field so as to prevent any further harm.

Read below for our full interview.

What inspired you to pursue social work?

A lot! I guess like I’ve always considered myself a kind of compassionate person. I don’t think there was ever a specific title or position I knew I wanted, but ultimately, social work just came up. I also think it differs from other disciplines because you’re focusing on people’s lives holistically versus just looking at the individual as a problem or as an issue; you’re looking at what are the other issues that are affecting this person’s life.

At the rainbow addiction services, what does your work week look like? And who are you interacting with? What are your general job tasks?

I worked with mainly LGBTQ+ & Two Spirit folks, basically just in identifying their own goals for their substance use. My role is basically group work and I do individual work as well. I’m a co-facilitator for groups. And right now, we break it down into stage one and stage two, and then there’s an IPT group, which is interpersonal therapy. In general, a group can look like, or include things like, psychoeducation on for example, triggers of substance use and why people might turn to substances. We work on things like exploring identity and self-esteem. Also, a big part of it coping skills and supporting people in finding healthier alternatives to cope with substances. And the individual group work is checking in individually with people on overall mental health. Sometimes, if people if it’s warranted, I’ll do a suicide risk assessment to determine their level of risk to themselves and others. Sometimes that means including recommending community or health supports outside of CAMH that they can access.

Did you specifically want to work with queer folks?

I’m going to say yes. Obviously, because of my own identity as a trans person, and figuring myself out and what that felt like for me and what that was for me. I also acknowledge that my life experiences were very fortunate: I’m super supported by a bunch of people. And I didn’t have a hard time. To be honest, internally, I had a hard time, but not from my family or my friends. And so not all queer people and trans people have that support. And so, yes, I wanted to work with that population, specifically. Because if I can be that one clinician that interacts in a really affirming way with somebody, I consider that a win.

Does CAMH maintain that same gender affirmation attitude as a policy or would you say there is more questioning and doubt?

I think there are a lot of issues with any organization. So, if you want to call yourself “gender-affirming”, and have a policy that says we’re inclusive and whatever, the question becomes, how are you practicing that? And how do you know that people are practicing that? If they’re not, how are they held accountable? And so, all of that being said, I, for some reason, just don’t feel like that happens all the time at CAMH. For example, even in the gender clinic, where you think people are affirming, I’ve had people say, as psychiatrists say to clients, for example, “what is your cup size?” And that is really fucking cringy.

What does DSM stand for?

The DSM really started as like transvestitism. It’s a diagnostic statistic Manual. We call it the Bible in social work. So, it’s the DSM 5 now that we work with. In the current DSM, we refer to what was previously “transvestitism” as gender dysphoria. In 2016, it was still gender identity disorder. We’re happy with the changes. So officially, it’s gender dysphoria, which is better. The reason why people need to get a diagnosis of gender dysphoria, again, the diagnosis, it’s a double-edged sword, is because, on the one hand, I have access to OHIP-funded surgery that says you need this as a treatment for your dysphoria. And I guess it’s a bit better than saying you have a disorder because now you’re saying that the distress is caused by your dysphoria. Is it the mental struggle or the issue? It’s not the actual trans identity. It’s the dysphoria. So a diagnosis is not always good but I appreciate that it allows for access to funding.

I read a few scary statistics and I’d like to get your professional analysis. the first one is: that 77% of trans youth have considered suicide.

I talked a little bit before about suicide risk assessments. And it’s very common for people to have, for example, really chronic passive suicide ideation. So essentially suicidal thoughts, with perhaps the intent to die or perhaps not with the intent to die but perhaps the intent to self-harm or numb pain. I think and that’s a very high number. The truth is that it’s shocking but not surprising. And also, I think the number of actual suicide attempts within the LGBTQ community is at, I think, 45% or something that has actually been attempted. So that’s almost half. That’s appalling and devastating. It’s way too high.

The second statistic is: that LGBTQ+ youth are approximately 14x more at risk of addiction and substance abuse.

Yes. The other thing, just before we talk about statistics some more is that data is oftentimes skewed. And what I mean by that, specifically, is that a lot of the times, the data that you’re referring to, I think racialized people are either specifically or strategically left out of the statistics, or they’re just not as represented for whatever reason.

And so, the addiction part and the substance use? Yes, I think it’s accurate. I’d like to refer to something called the minority stress perspective, which is basically a framework for thinking of stress specifically for minority populations, or I’d like to say marginalized populations, and it explains the additional unique stressors that marginalized and minority people experience. And so, these are things like microaggressions, violence, like anything, all of this stuff in addition to just existing as an identity, that’s not the norm or considered the norm. And so, I like to, I guess, use that as a framework for thinking about these issues, I think it’s really important to keep that in the back of your mind, right? So, yeah, in relation to substance use, if we think about all of the pain and trauma and cumulative trauma that results from being misgendered, from receiving death threats from violence etc. This is a cumulative effect. This is trauma. And so, LGBTQ & Two Spirit people are at a much higher risk for these things. And so, it’s not surprising that they turn to things like substances as a way of coping, and it’s unfortunate, an unhealthy coping strategy, but it’s a very common one. And so to me, that statistic is not surprising.

I was reading in one article that biphobia is one of the biggest issues within the queer community. So, even if you are a part of the queer community, there have been studies that report that biphobia is still prominent within the queer community. So that being said, one study found that 30% of bisexual youth said they had contemplated suicide in the last year and 15% of adults in the same category answered the same.

I would also like to preface this by saying that I have a friend who is bi and she specifically identifies as bisexual versus pansexual even though oftentimes they’re interchangeable. And she’s like, “I consider myself pan[sexual] but I use the word bisexual for that purpose, because there’s little representation of bi people but a lot of stigma and discrimination”. And I think that’s one of the reasons why there’s a lot of lateral violence that happens in the LGBTQ+ communities. And what I mean by that is I’ve seen gay people discriminate against trans people for the way that they present, talk, walk, etc. And vice versa. So, it’s not surprising that bi people sometimes feel like they have to really assess themselves and ask “Is being bi a thing?” And I think that it stems from peer pressure. Maybe all of that denial and discrimination leads them to question their own identity and potentially confuses them even more.

How do you, in your profession, deal with queer stigma? Biphobia, transphobia, homophobia, etc?

Very hard question, in my opinion. I don’t think I’ve seen a lot of it in my work, just because I work with LGBTQ+ & Two-Spirit communities. But as I said before, I have seen the lateral violence and people questioning other people’s identities. Not in a group setting, but more individual. I’ve also seen people have a sense of internalized homophobia and biphobia. For example, in group settings, we have group norms. So, we’ll say things at the beginning, like any discrimination of any kind will not be tolerated and it will be addressed. And that tends to be okay: folks don’t usually discriminate. Also, because they realize that again, they chose to be here. This is an LGBTQ+ thing. So, you should be in it together not focusing on what separates you, right? So that tends to work. I’m also very, very careful and conscious about my own self disclosure in practice, like whether or not I want to tell people that I’m trans. Whose benefit is it for, right? Is it for my own, if I disclose it for them to feel a sense of rapport or trust, or, like a sense of ease?

Why is it important or unimportant to acknowledge intersectionality and intersections when discussing queerness, queerphobia and issues with substance abuse?

I think it’s crucial. I think, much like the minority stress perspective, queerness intersects with ability, race, gender, etc. And, you know, a black activist coined the term intersectionality: Kimberlé Crenshaw. And it’s important, it really talks about our identities, how they intersect, how they don’t, what identities of mine have power, what identity identities of mine are oppressed, and how, as I call them, like subject position: how my subject positions change with the context of my environment, or like where I am. For example, I’m a mixed race. I’m the half Caribbean, half white, trans, and able-bodied. I’m also educated, right? And I think in certain contexts, maybe that’s warranted and in other spaces, maybe I really don’t feel like my trans identity would be welcomed in some circumstances. And so that’s what I mean by your subject positions, they change. What we need to do is appreciate storytelling and lived experiences as evidence-based. My feelings as a trans person and my experiences as a trans person in the healthcare system and in the social system…my experiences with people who are transphobic are 100% evidence-based.

What are some changes you’d like to see within current mental health/addiction institutions?

Shorter wait times for sure. I want to say this in the most respectful way possible so that my message comes across very clearly: LGBTQ+ people and Two-Spirit people face discrimination and all of these bad things. And they’re not responsible for those things. But what they are responsible for, I guess, is figuring out a healthier way to cope. So, it’s kind of like, Wow, I’ve been dealt a really shitty card. But now, it’s on me to kind of pick up the pieces. And so that being said, I feel like there need to be more clinicians, regardless if it’s a population-specific addiction program. I think all clinicians need to be educated on the intersections of identities. And they need to be respectful and gender-affirming and sexuality affirming, sex-positive, and all of that stuff. And if you feel like you can’t work with a specific population, you’re in the wrong field.

What are some changes that you’d like to see in society as a whole in relation to stigma and our perceptions of addiction?

Gabor Maté is a Hungarian psychologist. He’s situated right now in Vancouver, though, where there’s an ongoing severe opioid crisis. One of the things that he says is that the opposite of addiction is connection. And so that is how we should be looking at substance use and addictions. This mentality could provide huge prevention and change. Celebrating, accepting, and including LGBTQ+ & two-spirit communities, I think, is a form of connection. I also, I guess, in general, I’d like to see people just simply be kind. And even if they don’t know about someone’s identity, or don’t understand it, just to be kind. And lastly, what I would like to see, I think, there are so many depressing sad statistics about our communities, but there’s also so much vibrancy, strength, and resiliency, and I think that is important to see as well.

What does Pride month mean to you? Do you have any criticisms?

Pride can be a great way for community members to feel heard, feel seen, and acknowledged. I’m not denying that at all. There are a lot of criticisms about big corporations [with rainbow washing] essentially capitalizing on Pride and then they don’t actually support queer people the other 11 months of the year. I do know, however, that Scotiabank, I think recently in their benefits package, added something like supporting people through specific transition-related stuff which they now cover. Things that wouldn’t be covered through OHIP. So like electrolysis, for example, which is hair removal. That’s actually a small step in the right direction. The other thing is, I personally think it is so fucking ironic that you have Marsha P. Johnson, a black trans woman, and Sylvia Rivera, who’s half Puerto Rican, half Venezuelan, who started pride. I think it’s ironic that these identities paved the way for what we think of pride, and what it is today, and yet those populations, trans black trans women particularly, are amongst the highest to be involved in sex work and to be at risk of violence and murder. They’re literally at the highest risk that we don’t even talk about it and they don’t get published. We don’t hear about it. So, to me, that is very fucking ironic.

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