Launching the new, national, guide for the research community
On October 16th, 2024, the Partnership for Women’s Health Research Canada (PWHR) in collaboration with the Women’s Health Research Institute (WHRI) hosted the Beyond the Binary National Knowledge Exchange. This event brought together more than 200 attendees including trainees, researchers, as well as representatives from government and community organizations. Attendees joined from across Canada, the United Kingdom, and the United States of America. The Knowledge Exchange showcased Beyond the Binary (BTB) history, process, lessons learned, integrated principles and practices, and highlighted the people engaged throughout the project.
Much like its predecessor, Beyond the Binary in BC, this national collaboration culminated in the launch of a Guide.
Funded by a Canadian Institutes for Health Research Institute of Gender and Health Planning & Dissemination Grant, BTB Canada expanded upon the work of Beyond the Binary in BC, creating an updated and nationally relevant version through Pan-Canadian input from researchers, community members, and research administrators.
Importance of Gender Inclusive Research
Beyond the Binary acknowledges how research is a key determinant of health equity. For healthcare practices, programs, and policies to respond to people’s needs adequately, research must include them. When it comes to gender equity, acknowledging sex and gender-based determinants among cisgender women is beginning to improve health outcomes—but there is still more to be done. Also, health research has long conflated sex and gender, and women’s health research has not always been inclusive of trans, nonbinary, gender fluid and gender diverse people. This contributes to gender-based inequities.
Advancing gender inclusive research does not require the erasure of ciswomen. Some research might focus specifically on how being a ciswoman is a determinant of health. However, whenever relevant, the inclusion of trans, nonbinary and gender diverse individuals is needed to mitigate erasure, stigmatization, misrepresentation, and the resulting perpetuation of gender-based inequities.
The release of Beyond the Binary in Canada
The Beyond the Binary in Canada (BTB-C) Guide (available in English and French) aims to support gender inclusive language practices into health research processes. More than a prescriptive toolkit, the BTB-C Guide emphasizes and illustrates why language matters, which approaches are conducive to gender inclusive research, and how to sustain implementation of the suggested practices.
The presenters included members from the BTB Community Task Force, Research Task Force, and Core Team. They shared lessons learned about incorporating gender-inclusive research practices, including trauma and resiliency informed research, and reflecting on their own experiences working within the Beyond the Binary team.
Meet the Speakers:
Trauma and resiliency-informed research and good practices with BC Pomeroy & Dana Ross
The National Beyond the Binary Resource Package Overview with Lori A. Brotto & Heather McCain
Sharing implementation strategies for inclusive language and gender-equitable research with Kathryn Dewar, Bethan Kingsley, and Jack Woodman
Questions and Answers: Open Forum with Nicole Prestley
Key takeaways: Reflections on and learnings from the Beyond the Binary Canada process with Fritz Pino, Teffer Adjemian, Natalie O. Rosen, and Tamil Kendall
Within the presentation, speakers reflected on the emotional labour associated with commitments to gender-inclusive practices, and on how the discomfort of not knowing enough or making mistakes can cause people to disengage. In addition, The BTB team shared push back they experienced concerning commitments to gender equitable practices, noting how it is to be expected.
Speaker's key takeaways from BTB-C:
The Beyond the Binary in Canada guide can be used to support efforts that aim to:
Educate the research community about the importance of gender inclusive considerations in research.
Enter into conversations about gender-related health inquities people are experiencing.
Establish that trans, nonbinary, gender fluid and gender diverse people need to be included in research.
Engage with community. Those with living experiences of inequities we aim to address should be actively involved as partners in research.
The guide includes examples of how inclusive health research practices can be integrated across the components of the research cycle.
Speakers identified growth areas for gender inclusivity in research:
Normalize the use of cis and cisgender. When we only specify the gender identities and expressions of trans, nonbinary and gender diverse individuals, we adhere to cisnormativity and perpetuate binary thinking of anything outside of “woman” as “other”.
Per the Guide, cisgender is defined as a person whose gender identity correlates with the sex assigned to them at birth.
Cisnormativity is defined as the system of beliefs that favours cisgender people and other people who are not cisgender.
Establish research practices that increase engagement with intersex individuals. The “I” in 2S LGBTQIA+ is rarely recognized or represented, and research engagement can be designed to inform understanding of sex and gender from intersex perspectives.
Intersex is a term used to describe people born with reproductive or sexual anatomy, genetic makeup, and/or hormonal levels that are not characteristically male or female. Intersex people may identify as cisgender, trans, and/or nonbinary, and may not necessarily identify with the word intersex.
Advocate for and appropriately resource community-engaged research. Funding enables greater and more equitable engagement (compensation), and determines knowledge translation activities (graphic design, web hosting, etc.). Forming trusting relationships takes time. This requires resourcing.
Call in our own research community to address ongoing experiences of harm (discrimination, stigma, oppression). As agents within systems of care—including healthcare research—we can identify opportunities for our systems to conduct themselves in alignment with gender inclusive practices. One possibility identified was to engage Research Ethics Boards and individual reviewers to promote gender inclusion in health research.
Inform gender inclusive healthcare practices. Translate the lessons learned from “Beyond the Binary” to guide clinical practices that mitigate cis-centric assumptions of health-related experiences (e.g. associating pregnancy with womanhood). Suggested strategies include: integrating gender inclusive and trauma informed care training into: medical school curricula, continuing medical education offerings, and healthcare and research staff onboarding.
Closing Remarks
To close the event, Dr. Tamil Kendall, Director of PWHR shared wise words from Elder Sandy Leo, saying “you have to go slow to go far.” This phrase was spoken during Elder Sandy Leo’s engagement with Beyond the Binary in 2022 and has been a guiding principle since then for the BTB team to be vulnerable, practice reflexivity and continue to foster genuine relationships as the project continues to evolve and grow.
Further, speakers expressed how inclusion begins with the words we use and the importance of BTB-C as a steppingstone for more gender inclusive research practices and processes to be actioned within the research community.
The Beyond the Binary Knowledge Exchange and the release of the BTB-C Guides were a tremendous success. The WHRI extends its gratitude to everyone who attended, downloaded the guide, and shared their experiences. Participation in the BTB Knowledge Exchange was crucial in advancing gender-inclusive health research. Special thanks to the BTB-C team, community partners, and collaborators for making this possible. Together, we’re fostering meaningful change.
Read more about the provincial to national path of Beyond the Binary here.
Download the Beyond the Binary in Canada guides, in English and French. Watch the video recording from the Knowledge Exchange on PWHR’s YouTube Channel.