Indigenous gender identities

There are many ways of being. Gender diversity is a normal and important part of human diversity. The existence of more than two genders is well-documented around the world and across cultures dating back many centuries.

Colonization has attempted to violently erase this history and the existence of gender diversity. For this reason, many communities have been on a long healing journey to reverse damaging colonial influences and take steps to ensure that Indigiqueer Indigiqueer is a term coined by TJ Cuthand and popularized by Joshua Whitehead to refer to people in the Indigenous queer community. Indigiqueer includes people who do not hold Two-Spirit identities, although Two-Spirit identities are part of the Indigiqueer community. , trans and Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) people are safe and welcome.  

The Indigiqueer, trans and Two-Spirit people in our communities keep this history alive. They teach loved ones and shape what these terms mean today. Across Turtle Island, this resurgence is having a profound impact as reconciliation moves forward and healing continues.

There are many words that describe Indigenous gender, sexual orientation Refers to terms such as lesbian, gay, straight, and queer, which are based on patterns of emotional, romantic, and/or sexual attraction to groups of people. Sexual orientation terms are commonly (but not always) defined by the gender(s) of the people that the individual is attracted to. Sexual orientation also refers to a person’s sense of identity based on those attractions, related behaviors, and membership in a community of others who share those attractions; for example pansexual, bisexual, LGB, heterosexual. and cultural identity. This includes many terms unique to specific Indigenous languages. English words that some gender diverse Refers to gender roles and/or gender expression that do not match social and cultural expectations. Indigenous people may use today include trans, Indigiqueer, non-binary Umbrella term referring to people whose gender does not fall within the binary gender system of woman/girl or man/boy. Some individuals identify as non-binary while others may use terms such as gender non-conforming, genderqueer, or agender. Non-binary people may or may not conform to societal expectations for their gender expression and gender role, and they may or may not seek gender-affirming medical or surgical care. , and Two-Spirit. You may identify with one of these terms, another 2SLGBTQIA+ identity term or may find a word in your own language that fits for you.

Two-Spirit people

“Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) ” is a broad umbrella term and means different things to people who use it. Some Two-Spirit people consider themselves to be gender diverse Refers to gender roles and/or gender expression that do not match social and cultural expectations. , non-binary Umbrella term referring to people whose gender does not fall within the binary gender system of woman/girl or man/boy. Some individuals identify as non-binary while others may use terms such as gender non-conforming, genderqueer, or agender. Non-binary people may or may not conform to societal expectations for their gender expression and gender role, and they may or may not seek gender-affirming medical or surgical care. or trans; others may not.

Depending on a Nation's or individual's unique understanding of the term, Two-Spirit may refer to cultural, spiritual, sexual and gender identity A person's deeply held, internal sense of themself as male, female, a blend of both or neither. (Source: GenderSpectrum.org) . Since Two-Spirit applies to many aspects of identity, the terminology each person uses will depend on what it means to them.

There has been a resurgence of Two-Spirit leadership within 2SLGBTQIA+ and Indigenous and non-Indigenous communities. Today, there are many celebrated Two-Spirit and Indigiqueer Indigiqueer is a term coined by TJ Cuthand and popularized by Joshua Whitehead to refer to people in the Indigenous queer community. Indigiqueer includes people who do not hold Two-Spirit identities, although Two-Spirit identities are part of the Indigiqueer community. youth, elders, authors, artists, musicians, leaders, ceremonies, resources, community organizations and events. Connecting with your local Two-Spirit organization can help you find some of these people, events and resources in your community or online.

Gender-affirming health benefits

In addition to provincial health care coverage (MSP The Medical Services Plan (MSP) is a B.C. government health plan that pays for physician services and referred services that are considered medically necessary, such as specialists (surgeon, psychiatrist, etc.), diagnostic x-rays, or laboratory services, for all BC residents. Some residents qualify for premium assistance for physiotherapy, chiropractic, naturopathy, massage therapy and acupuncture. ), Indigenous community members may receive coverage through other benefits plans. Below you'll find information on gender-affirming health care benefits for those covered by:

• First Nations Health Authority (FNHA)
• Non-Insured Health Benefits (NIHB)
• Their band
• Métis Nation of British Columbia (MNBC)

As benefits and eligibility may change over time, consider reaching out to the organizations listed below for confirmation of current details.

What’s covered through FNHA?

Mental health 

There are several coverage options for mental health support, all of which are available for trans and Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) clients, but are not specific to gender-affirming care Processes through which a health care system cares for and supports an individual while recognizing and acknowledging their gender and expression. . You can find more information on available mental health services and clinicians at First Nations Health Authority or read our section on How to Find a Counsellor. 

Gender-affirming items

FNHA has coverage for gender-affirming garments such as binders, packers, dilators, breast forms, gaffs and stand-to-pee devices. These items must be ordered by a provider and are eligible for coverage up to a pre-set amount. For general questions, or if your pharmacy does not carry the item you require, you can speak with an FNHA Medical Supply Assessor.

Medications 

Any medication covered by BC PharmaCare is also covered by First Nations Health Authority. Coverage includes a wide selection of medications used for hormone therapy such as estrogen, hormone blockers, and testosterone.

Please contact the Health Manager at your band office or FNHA to confirm coverage for prescribed medication. If it is not covered by BC PharmaCare BC government program that helps residents with the cost of eligible prescription drugs and medical supplies. , you can submit a special request for coverage to FNHA. These requests are reviewed on a case-by-case basis. 

Surgery

Any gender-affirming surgery covered by MSP is also covered by First Nations Health Authority. Visit our Surgery page to learn more about your options. Visit our Surgery page to learn more about your options.

Medical supplies

There may be some medical supplies such as bandages and antiseptic washes that patients need when preparing for and recovering from surgery. FNHA provides coverage for these supplies on a case-by-case basis. For more information, you can contact the Health Manager at your band office or First Nations Health Authority. 

Travel

Some aspects of gender-affirming care may involve travelling to other communities or urban areas, for instance surgery and hormone readiness assessments. Travel for any medical service (such as surgery or a medical appointment) may be covered through MSP’s Travel Assistance Program or FNHA’s Patient Travel benefits program.

If the service you require is not covered by MSP or FNHA, you can submit a special request for coverage to FNHA. These are reviewed on a case-by-case basis.

Travel for medical services may also be covered by your band. Coverage (such as the types of services being accessed or who can travel with you) will vary. Please contact the Health Manager at your band office for more information.

Eligibility for FNHA benefits

Health benefits for Status First Nations people in B.C. are administered through the First Nations Health Authority. For others (specifically belonging to Treaty Nations), services are directly covered through the federal Non-Insured Health Benefits (NIHB) program.

Some health services not covered directly by FNHA may still be covered by NIHB, or may be covered by individual bands. Health Managers at local band offices can be helpful contacts when exploring coverage.

To receive health benefits under the FNHA’s Health Benefits program you typically must: 

• Be a First Nations person with "Indian status"
• Live in BC based on the requirements outlined by Medical Service Plan

You are not eligible for FNHA coverage if you have health insurance provided by:

• The federal government 
• A First Nations organization as part of a self-government agreement with Canada 

Métis Nation British Columbia (MNBC) 

Métis Citizens may be eligible for counselling and other social service supports through MNBC, such as:

• The Miyoopimatishihk (Wellbeing) Program (for children under eight years) — Families can apply for financial support to assist with the cost of various services, programs and products, including respite care, speech therapy, assessments, specialized equipment and mental health supports. 
• Métis Counselling Connection Program (all ages) — This program covers the expenses, for those with financial need, of up to ten 60-minute counselling sessions provided by registered counsellors, social workers, psychologists or psychiatrists. Métis Regional Mental Health Navigators at MNBC can support access to mental health supports in your region. 
• Elders Temporary Financial Support — MNBC Ministry of Elders assists our low-income Métis Elders/seniors whose income has been impacted by COVID-19 in obtaining groceries, household goods, or medications.

For more information on Métis Citizenship, please visit the MNBC website.

Jordan’s Principle 

Jordan’s Principle is a legal requirement that applies to First Nations children. You can apply for consideration of coverage for things like: 

• Private-pay readiness assessments
• Fertility treatment
• Mental health support
• Post-op supplies and equipment.

The Jordan’s Principle Handbook provides further details and to access services you can connect with your local service coordinator.

Culturally-relevant resources

Groups and initiatives

• Dancing to Eagle Spirit Society — This is a Vancouver-based organization dedicated to healing and empowerment of Two-Spirit individuals. Participate in trans positive and inclusive ceremonies led by Tsleil-Waututh, Two-Spirit and trans Elders on Tsleil-Waututh Territory.
• Four Feathers Society — This group provides opportunities for Indigenous 2SLGBTQIA+ communities to come together for community events, education, and creative expression. The society holds a Two-Spirit Sweat Lodge on Squamish Territory (North Vancouver) for Two-Spirit folks and allies.
• Urban Native Youth Association (UNYA) — This Vancouver organization has a range of Two-Spirit inclusive services for Indigenous youth, including some programming specifically designed for Two-Spirit youth. One such program is the 2-Spirit Collective. This program provides support, resources and programming for Indigenous youth, ages 15 to 30, who identify as Two-Spirit or LGBTQ+, and for those who are questioning A term sometimes used by people in the process of exploring their gender or sexual orientation or who choose not to identify with any other label. (Source: QMUNITY) their sexual or gender identities.
• CampOUT! — This social justice summer camp is for queer A reclaimed term for non-heterosexual or non-cisgender people. "Queer" provides convenient shorthand for "LGBT2Q+", and is also used by some people to describe their personal identities. , trans, Two-Spirit, and allied youth from British Columbia and the Yukon. It takes place every July near Vancouver, with leadership and camper applications beginning in February.
• Indian Residential School Survivors Society — This provincial organization provides essential services to Residential School Survivors, their families, and those dealing with Intergenerational traumas. Indigenous trans, Two-Spirit and other LGBTQIA+ Indigenous people are able to connect with their Resolution Health Support Worker and LGBTQ+ Liaison for support, interim counselling, and cultural connection and ceremony. 
• Peer Support Groups — Use the Trans Care BC peer support directory to locate peer support groups in your community.

Online resources

• Native OUT — This non-profit education and media organization, actively involved in the Two-Spirit movement. They utilize the internet, through their website, multimedia and social networks to educate about the Indigenous LGBTQ+ and Two-Spirit people of North America.
• Native Youth Sexual Health Network — This group has a national campaign for First Nations youth across Canada to fight homophobia and normalize healthy sexuality.
• North American Aboriginal Two-Spirit Information Pages — This is a great site for researching articles and information on Two-Spirit and Aboriginal issues, hosted by the University of Calgary.
• Two-Spirited People of the First Nations — This group provides prevention education and support for Two-Spirit people, including First Nations, Métis and Inuit people living with or at risk for HIV and related co-infections in the Greater Toronto Area. Work is based on Indigenous philosophies of holistic health and wellness.
• You Are Made of Medicine — Download a copy of the Two-Spirit Mental Health Peer Support Manual by Native Youth Sexual Health Network.
• A Place in the Circle — This Two-Spirit Métis Awareness Resource is a document for helping understand and support Two-Spirit people.
• Community-Based Research Centre’s Medicine Bundle — This organization provides free sexual Health medicine bundles containing an HIV self-test kit, Indigenous medicines (sage, sweetgrass, tobacco, cedar, lavender, Labrador tea, bear grease and Devil's club salve), sexual health supplies, and additional resources.
• Two-Spirit Journal — This platform is a Two-Spirit media and news site. It includes links to current and upcoming events, news stories, research, editorials, community dialogues, and more.
• 2 Spirits in Motion Society — This is an organization for and by Two-Spirit people across Turtle Island. Through the guidance of various councils, this society aims to create, maintain and strengthen an affirming environment for 2SLGBTQIA+ people to celebrate their authentic selves.
• University of Alberta: Indigenous Canada course — This online course that explores the histories and contemporary perspectives of Indigenous people in Canada. Module 9 in the course explores the concept of gender and the impact of colonization.
• Reclaiming Power and Place — Download a copy of the National Inquiry into Missing and Murdered Indigenous Women and Girls.

Books

• A Two-Spirit Journey: The Autobiography Of A Lesbian Ojibwa-Cree Elder. Ma-Nee Chacaby & Mary Louisa Plummer, 2016.
• Queer Indigenous Studies: Critical Interventions in Theory, Politics, and Literature (First Peoples: New Directions in Indigenous Studies). Driskill et al, 2011.
• Spaces between us: Queer settler colonialism and Indigenous decolonization. Scott Lauria Morgensen, 2011.
• Spirit and the Flesh: Sexual Diversity in American Indian Culture. Walter L. Williams, 1992.
• Two-Spirit People: Native American Gender Identity A person's deeply held, internal sense of themself as male, female, a blend of both or neither. (Source: GenderSpectrum.org) , Sexuality, and Spirituality. Jacobs, Thomas & Lang, 1997. 
• The Zuni Man-Woman. Will Roscoe, 1992.

Films

• Face to Face with Jack Saddleback (2014) 
• Regalia - Pride in Two-Spirits (2015) 
• Two Hard Things, Two Soft Things (2016, iTunes release summer 2018) 
• Two-Spirits (2009) — A documentary exploring the cultural context behind a tragic and senseless murder of a young Two-Spirit Navajo person
• Two Spirits, One Voice EGALE (2016) 

Academic Articles

• Driskill, Qwo-Li. (2011) "Doubleweaving Two-Spirit Critiques: Building Alliances between Native and Queer Studies." GLQ: A Journal of Lesbian and Gay Someone who is primarily attracted to those of the same gender. The term is often but not exclusively used to refer to men. Studies, vol. 16 no. 1, 2010, pp. 69-92. Project MUSE, muse.jhu.edu/article/372445.
• Frazer, M. Somjen and Pruden, Harlan. (2010). Reclaiming Our Voice :Two Spirit Health & Human Service Needs in New York State. NYS DOH AIDS Institute: Albany, NY.
• Sarah Hunt & Cindy Holmes (2015) Everyday Decolonization: Living a Decolonizing Queer Politics, Journal of Lesbian Studies, 19:2, 154-172
• Hunt, S. (2016). An Introduction to the Health of Two-Spirit People: Historical, contemporary and emergent issues. Prince George, B.C.: National Collaborating Centre for Aboriginal Health.
• Ristock, Janice & Zoccole, Art & Passante, Lisa & Potskin, Jonathon. (2017). Impacts of colonization on Indigenous Two-Spirit/LGBTQ Canadians' experiences of migration, mobility and relationship violence. Sexualities.
• Ayden I. Scheim, Randy Jackson, Liz James, T. Sharp Dopler, Jake Pyne, Greta R. Bauer, (2013) Barriers to well-being for Aboriginal gender-diverse people: results from the Trans PULSE Project in Ontario, Canada, Ethnicity and Inequalities in Health and Social Care, Vol. 6 Issue: 4, pp.108-12.
• Wesley, D., & Morgensen, Scott. (2015). Reimagining Two-Spirit Community: Critically Centering Narratives of Urban Two-Spirit Youth, ProQuest Dissertations and Theses.
• Wesley, Saylesh. (2014) Twin-Spirited Woman: Sts'iyo´ye smestı´yexw slha´:li. TSQ: Transgender Studies Quarterly 1.3: 338-351.
• Wilson, A. (2008). N'tacimowin inna nah': Our Coming In Stories. Canadian Woman Studies, 26(3/4), 193-199.

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