Tag Archives: diversity

Quebec promises diversity training for health-care workers in wake of Joyce Echaquan’s death

A little less than a month after taking over as Quebec’s Indigenous affairs minister, Ian Lafrenière has announced a $ 15-million plan to teach health-care workers how to better provide services to members of Indigenous communities — with an emphasis on cultural safety.

That means providing care in accordance with Indigenous norms and traditions.

The announcement is a direct response to the death this fall of a 37-year-old Atikamekw woman at a hospital in Joliette, Que., a town about an hour north of Montreal.

In late September, Joyce Echaquan did a Facebook live of her treament in her hospital room shortly before her death. Viewers could hear her pleas and the staff’s response: degrading and racist insults.

The exact cause of her death is still not known.

Lafrenière was accompanied by Health Minister Christian Dubé as he told reporters the government wants to remove barriers for Indigenous communities in the health and social services network. 

“We would like to regain trust from different nations,” Lafrenière said.

Echaquan’s death sparked protests, a public inquiry and a public apology from Quebec Premier François Legault at the National Assembly.

WATCH | Lafrenière says Quebec’s efforts are not just about ‘image making’:

Ian Lafrenière, Quebec’s new minister of Indigenous affairs, says the province is “talking about facts” and not just concerned with “image making.” 0:49

Cultural safety was a key component in the Viens Commission’s 142 recommendations, which documented the discrimination Indigenous people face when receiving public services.

The cultural-safety training is expected to be rolled out gradually, starting with hospitals that take in more Indigenous patients — such as Joliette Hospital where Echaquan died  — before eventually being implemented across the province.

A team at l’Université du Québec en Abitibi-Témiscamingue developed the training guide, and Indigenous community leaders will have a chance to weigh in on its contents.

“There are many subtleties that we need to have in the training and this is the reason we want to involve them,” Dubé said.

The province will also hire liaison agents and health-care “navigators” who will serve as go-betweens for hospitals and members of Indigenous communities, with the navigators expected to come from Indigenous communities.

“Today, this is not image making, this is facts,” said Lafrenière. “We’re not telling you it’s going to be done within a week. It’s going to be a long process.”


Joyce Echaquan’s mother is seen at a vigil after hear death at the Joliette, Que., hospital. (Ivanoh Demers/Radio-Canada)

‘This is one announcement, this is not the last one’

The $ 15-million investment is part of a $ 200-million envelope set aside by the CAQ government in its latest budget.

It’s also Lafrenière’s first major move since replacing Sylvie D’Amours as the Indigenous affairs minister.

“This is one announcement, this is not the last one,” he said. “Let’s hope for the future, work for the future.”

His appointment last month raised eyebrows and drew criticism, due to his history as a high-ranking Montreal police officer. Indigenous communities have said their relationship with Montreal police is a tense one.

Lafrenière promised swift action, and claimed his experience with the SPVM was an asset in his new role, not a liability.

Following Echaquan’s death, voices calling for the CAQ government to recognize systemic racism grew louder, but Legault and Lafrenière, have both denied it exists in the province.

WATCH | Legault apologizes following Joyce Echaquan’s death

François Legault said the Quebec government has a duty to treat everyone with dignity and respect. He said Quebec failed that duty by allowing Joyce Echaquan to die amid racist taunts. 1:05

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Akim Aliu, Vanessa James, Asher Hill know fight for diversity on ice is just beginning

The landscape on ice is changing rapidly.

For years, hockey and figure skating have been dominated by white athletes, and to varying degrees, they still are today.

But three Black competitors on the sixth season of Battle of the Blades — former NHLer Akim Aliu and figure skaters Asher Hill and Vanessa James — are making efforts to change that.

Aliu first spoke about the racism he experienced in hockey in November, when he said he was targeted by then-Calgary Flames coach Bill Peters while the two were in junior hockey together. Peters was fired soon after.

That revelation became the tip of the iceberg, with multiple other NHL coaches being called out for abuse.

In May, as the NHL was getting set to restart its season amid a worldwide racial reckoning following the death of George Floyd, Aliu and a group of BIPOC hockey players formed the Hockey Diversity Alliance (HDA).

WATCH | Aliu, James, Hill discuss diversity in respective sports:

Akim Aliu, Asher Hill, and Vanessa James are not only part of this season’s Battle of The Blades, but also diversity alliances in their sports. 8:14

Aliu, 31, was born in Nigeria and lived in Ukraine until he was seven and moved to Toronto. He serves as co-head of the organization alongside San Jose Sharks forward Evander Kane which pledges “to eradicate racism and intolerance in hockey.”

In July, the HDA made a series of requests to the NHL including more inclusive employment practices and supporting social justice initiatives that target racism, among other asks.

Earlier this month, unsatisfied with the NHL’s response, the HDA cut ties with the league over what it called “performative public relations.”

“It would be a lot easier to implement some of the things we want to do in some of the NHL cities with their fans and with their following but they’re not there yet,” Aliu told CBC Sports’ Jacqueline Doorey.

“They feel that things are good status quo and we don’t, so we feel it’s up to us to take the reins of the conversation and I do believe that sooner or later they’ll have no choice but to jump on board.”

Aliu said he’s encouraged by the first few months of the HDA despite the difficult relationship with the league.

“I think we found a little bit of trouble getting pulled in different directions with some of the objectives and missions that we had, but we stuck together as a group and I feel like we’re doing a lot of good in the game of hockey right now and in society as well,” he said.

The goal now is to ensure the conversation around racial injustice in hockey doesn’t get swept under the rug.

“We didn’t want it to be a moment, we wanted it to be a movement. So we don’t want it to be one of those trendy topics like it’s been in the past,” Aliu said.

Aliu is paired on Battle of the Blades with James, a six-time French pairs champion, 2018 Grand Prix Final champion and 2019 European champion. The two are skating for The Time To Dream Foundation, which aims to make youth sports more inclusive and accessible.

WATCH | Powerful pause in sports:

Devin Heroux of CBC Sports reflects on a week in sports that saw a united show of solidarity across professional leagues in support of racial justice. 2:48

James says Aliu is making the transition from hockey to figure skating quite swimmingly.

“He’s phenomenal, he’s a hard worker, he’s naturally talented, very agile and flexible and he has these long legs that make beautiful lines when they’re straight. He’s doing a great job,” James said.

The two have already made a solid connection due to their shared experiences in predominantly white sports. James is also part of the Figure Skating Diversity and Inclusion Alliance (FSDIA), which carries similar goals to Aliu’s HDA.

“There’s always been a little bit of isolation and not feeling included. … If you look at [clothes] for figure skating, you don’t find tights for Black girls or people of colour, you don’t find skates that are the same colour, it’s hard to find matching things like that. So it gives the idea they’re not welcomed,” James said.

For James, the main goal is to ensure the next generation of figure skaters feel welcomed in their sport.

Hill, a 29-year-old ice dancer paired with hockey player Jessica Campbell, is skating for FreedomSchool – Toronto, which aims to intervene on anti-Black racism in the school system.

His mindset is similar to James in trying to create a more inclusive sport than he came into, and he’s also a member of the FSDIA.

“I think oftentimes we don’t see Black people in winter sports, [it’s] assumed that we don’t like the cold or we’re afraid of ice [or that] it’s a white man’s sport or a white person’s sport,” Hill said.

“But it’s just if you have access and if you’re able to do it and I think having the representation of so many Black athletes will show that you can occupy any space as long as you have the opportunity.”

Hill is aiming to create more opportunities and accessibility in the figure skating community. Like Aliu, he says the sport’s organizations fall short.

“I think it comes down to the mindset of the gatekeepers and the leaders in the sport which are our coaches and our federation heads. … It’s just changing the mindset that anyone can be part of figure skating as long as you give the opportunity,” Hill said.

Along with Aliu, James and Hill, former NHLer Anthony Stewart rounds out the Black skaters on the newest edition of Battle of the Blades. Beyond the ice, junior Canadian champion and international competitor Elladj Baldé will serve as a judge and singer Keshia Chanté joins Ron MacLean as a co-host.

“I think it’s a beautiful cast because there’s so much diversity and so much inclusion,” James said.

The season premiere airs Thursday at 8 p.m. ET.

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CBC | Sports News

‘The Bold Type’ Star Aisha Dee Calls for More Diversity Behind the Camera

‘The Bold Type’ Star Aisha Dee Calls for More Diversity Behind the Camera | Entertainment Tonight

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Sidelined: How diversity in Canada’s sports leadership falls short

For 14 years Clayton Pottinger had tremendous success as a basketball coach, his teams winning nearly 80 per cent of their games.

But an opportunity to coach at the next level never came.

As a Black head coach, he often wondered why.

“I don’t know a 100 per cent the reasons behind it. I don’t know that it was race related but I don’t discount that,” Pottinger told CBC Sports. “I was interviewed for three positions but overlooked — not even granted an interview dozens of times. It got to the point where I didn’t think it was going to happen.”

Pottinger’s story may sound like a tale often told south of the border, but his is a Canadian story.

Last March, he finally broke through and landed his first job at the Canadian university level when UBC-Okanagan named him head coach of its men’s basketball team.

Pottinger, 49, joined a small group of Black coaches who have reached the highest leadership positions in Canadian university sports.

For decades, North American professional sports leagues have been castigated for the dearth of Black and people of colour employed in key leadership and coaching positions.

An investigation by CBC Sports reveals that the issue is prevalent across Canadian sports.

A visual audit conducted by CBC Sports examined hundreds of key positions at all 56 Canadian universities that compete under the umbrella of national governing body U Sports, including the school’s athletic director and head coach of football, men’s and women’s basketball, hockey and soccer, and track.

Of the nearly 400 positions examined, only about 10 per cent were held by Black, Indigenous or persons of colour (BIPOC). Only one of the 56 schools has a non-white athletic director.

“You could go to any website at any university and you’d see one of the five principles or objectives is diversity and inclusion, yet you see the numbers in our studies, you see the [CBC’s] numbers,” said Dr. Richard Lapchick, founder and director of the Institute For Diversity and Ethics and Sport. The institute, based at the University of Central Florida, was the first to begin compiling racial breakdowns of hiring practices in the United States.

Lapchick said filling athletic leadership positions on North American college campuses is not always a result of overt racism, but rather a persistent old boys’ network.


(Illustration by Alexis Allison/CBC Sports)

“If you have a white athletic director and a white [university] president and they’re making the key hires in your athletic department, the people they know are more than likely to be white,” Lapchick said. “So they’re going to turn to them in that selection process as opposed to who [else] might be out there.”

The recent killing of George Floyd by police in Minneapolis in May has refocused the lens on racial inequality in everyday North American life. Hundreds of thousands of people have filled city streets demanding an end to systemic racism.

Many companies and organizations, including the CBC, have been forced to acknowledge both a lack of diversity among senior leadership, while addressing systemic racism in the way they conduct business both internally and externally.

The world of sports has not escaped this scrutiny.

Leagues condemn racism

In wake of Floyd’s death, professional leagues across North America issued statements condemning racism and promised to do better. Players demanded change. Leagues like the NFL, where 70 per cent of the players are Black or persons of colour, promised more would be done to reflect that in its coaching staffs and leadership. And after years discouraging outward signs of protest, like kneeling during the U.S. national anthem, NFL commissioner Roger Goodell came full circle and encouraged players to express themselves.

In Canada, the recently hired Pottinger says there is still a long way to go. UBC-Okanagan is one of only three universities in Canada to employ both a Black men’s and women’s head coach. He points to an undercurrent of bias when it comes to how leadership positions are filled.

“People of colour aren’t necessarily looked at as people with those abilities. We can shoot hoops, we can make baskets, we can make defensive plays,” Pottinger said. “But if you ask us to lead a team, then I think there’s always some question marks around whether or not you can do it.”

CBC Sports presented its findings to officials at U Sports and the four conferences that govern Canada’s university sports system.

None of the groups rejected or disputed the findings. But at the same time, it appears little has been done to formally track who is being hired and why.

The NCAA, governing body of college sports in the U.S., does maintain a database that tracks demographics for student-athletes, coaches and administrators. U Sports does not.


(Illustration by Alexis Allison/CBC Sports)

Most of the responses pointed to strides made in the area of gender equity but acknowledged little has been done to promote and encourage more BIPOC candidates and hirings.

Everyone involved in the upper reaches of Canadian university sport acknowledged there’s work to do when it comes to diversity in leadership positions.

At the same time, U Sports officials contend that, for the most part, they are powerless to change things. 

“One of our key principles is institutional freedom and as such hiring is based on member universities’ human resource policies in compliance with provincial labour laws,” the organization said in its statement.

Balancing act

Atlantic University Sport (AUS) executive director Phil Currie called it a balancing act. 

“The hiring of athletics directors or sport coaches/assistant coaches is done under the policies and practices of our member institutions and as such the AUS has no direct control of that process,” said Currie, who oversees athletics in the Atlantic provinces.

“CBC’s summary on the number of BIPOC head coaches demonstrates that, and we acknowledge that those numbers are not where they need to be,” he said.

The lack of diversity in leadership is equally stark among Canada’s key Olympic institutions. CBC Sports looked at the board of directors at the Canadian Olympic Committee and seven among the country’s largest national sport organizations: swimming, athletics, hockey, skating, basketball, volleyball and soccer.

Across them, around 100 board members are tasked with representing thousands of athletes. Only seven of these key positions are held by BIPOC. For example, the COC’s 17-member board is composed of 16 white directors and only one BIPOC.

“Our reflection following the events of the past month has reinforced that while we have made important strides in diversity and inclusion, we need to do more,” the COC said in a statement to CBC Sports. 


(Illustration by Alexis Allison/CBC Sports)

“Though our board of directors reflects diversity in a number of important measures, including gender, LGBTQ+, language, etc., there’s no denying that we have considerable work to do in addressing BIPOC diversity on our board.”

The COC vowed to change the makeup of its board by instituting a number of measures, including no longer simply relying on a public call for board nominations.

Across the board, national sports organizations contacted by CBC Sports acknowledge major shortcomings in the racial makeup of their key leadership positions.

Athletics Canada said it’s “probably the most inclusive sport in Canada in terms of racialized participation,” but said its board must “better represent what the sport looks like on the field of play.”

Basketball Canada also acknowledged a large gap between players and decision makers.

“Our Canadian national basketball teams are some of the most ethnically diverse in our country. However, we acknowledge that, off the court, our organization still has some work to do at a leadership level,” it said in a statement.

For some, change has been elusive. Hockey Canada said it’s been “working at various stages over the past few years to address areas of diversity,” but its entire board was comprised of  white males as of July 1.


Hockey Canada’s board of directors is comprised of all white men. (Hockey Canada)

CBC Sports also looked into 500 leadership positions across professional ranks and found that for the most part, they mirror the above findings.

CBC Sports compiled data that included team ownership, team president, general manager and head coach across seven major leagues: NFL, MLB, NHL, NBA, CFL, WNBA and the NWSL.

Only the NBA, where more than 80 per cent of players are BIPOC, according to research by the Institute for Diversity and Ethics in Sports, approached close to 25 per cent of leadership positions filled by people who look like the majority of its athletes.

In MLB, where 41 per cent of players are BIPOC, only seven of 100 leadership positions looked at are filled by people of colour.


Former CFL star Khari Jones had doubts he’d ever become a head coach before getting the job with the Montreal Alouettes in 2019. (Graham Hughes/The Canadian Press)

In the CFL, only about 10 per cent of the league’s key leadership positions are filled by people who aren’t white, a sharp departure from the league’s on-field racial makeup.

One of the league’s two Black head coaches is former quarterback Khari Jones, who has been head coach in Montreal since June 2019.

After a stellar career in the CFL, he worked as assistant coach for a decade in Hamilton, B.C and Saskatchewan.

Jones said he doubted whether he would ever be a head coach.

“You see so many African-American people play the game but not having the chance to coach and have lead roles,” he told CBC Sports. “It’s never deterred me. It’s just a sad thing, even when I knew I wanted to get into coaching and I knew my goal was to be a head coach.”

Jones says until more BIPOC people own teams or fill leadership roles with authority to hire, change will be difficult.

“All the owners are white, so you tend to go that route when hiring,” Jones said.

“It becomes really disheartening when you don’t think you have a real chance, or you don’t have an opportunity to get a job that other people seem to be getting.”

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Why this Toronto man is trying to boost diversity on Canada’s stem cell registry

In 2014, Tom Wong learned he had Myelodysplastic syndrome (MDS), a rare form of blood cancer.

The disease prevented his stem cells from maturing — meaning they couldn’t carry oxygen, fight infections or help his body heal from bruises.

He found himself on the Canadian Blood Services Stem Cell Registry waiting for a match.

“They kept telling me that my best chance of a match was going to come from a male within my own ethnicity,” he said.

But Wong found out a match from his Chinese background would be hard to come by.

Out of the 450,000 Canadians registered with Canadian Blood Services as potential stem-cell donors, 68 per cent are white and about six to seven per cent are Asian. Even fewer are Chinese.

“When I heard these stats I decided to try and do something about it,” he said. “So I go out to communities to talk and go out to universities and corporate events just to get a more ethnically diverse mix into the database.”


Canadian Blood Services says right now its registry is almost 70 per cent Caucasian. (CBC)

Five years after his journey began, the numbers haven’t moved much.

The amount of diverse registrants have risen three per cent from 28 to 31 per cent overall, but the numbers for many ethnicities are still low.

For example, black and Indigenous donors each make up less than one percent of the registry.

Finding a match

According to Jonas Mattsson, director of the Hans Messner stem cell program at the Princess Margaret Cancer Centre, a successful match occurs when patients have similar human leukocyte antigen (HLA) systems, responsible for regulating the immune system.

“It’s like a personal signature that we have on our own cells. Those signatures actually play a very important role in the immune system,” he said.


(Submitted by Canadian Blood Services)

“It should be the same signature between the patient and the donor.”

In some cases, a match can be found in a sibling, as half of your HLA system comes from your mother and half from your father.

If that’s not successful, the next place to look for a match is in a patient’s ethnic group.

Through his advocacy, Wong found one of the reason why many Chinese people haven’t signed up is because they don’t want anything to be taken out of their body unnecessarily.

“I’m finding that there’s more people … that are more receptive now,” he said. “I’m happy to hear that.”


Sharr Cairns with Canadian Blood Services says one of the reasons why some people don’t donate is because they’re frightened of the process, but she says donating stem cells is similar to donating blood. (CBC)

Sharr Cairns, the Ontario territory manager for the Canadian Blood Services Stem Cell Registry, said she can’t pinpoint why certain groups don’t register, but she does believe many people are misinformed about how stem-cell donation actually works.

“I think what happens is a lot of people are frightened of the program,” she said.

“It’s very similar to a blood donation, so we hook you up to a machine that does all the work.”

Cairns said although they have work to do to encourage more diverse adult stem cell donations, they are seeing more diversity through their cord-blood bank.

The program runs at Brampton Civic Hospital, and Cairns said that registry is up to 60 per cent diversity.

Cairns said at any given time, about 1,000 Canadians are looking for a stem cell match.

To improve the registry’s diversity, she said people like Wong are the ones making a huge difference.

‘He has been a great advocate’

“Unfortunately, with a lot of our programs at Canadian Blood Services, people tend to not really take notice until they see someone from their own circle of family or friends who is in need,” she said.

“He has been a great advocate for us.”

Wong continues to do speaking events in many communities, from Asian to Jamaican to South Asian.

A few weeks ago, he said students at a Bramalea Secondary School gave him hope.

He planned a swabbing event and 88 graduates turned out. That’s crucial, he said, because men between 17 and 35 are ideal donors as their stem cells provide a better post transplant survival rate.

“I’ve never had more than 25 people at one event and these 88 kids were heroes,” he said.

Wong found his match in Germany

As for Wong’s case, he didn’t end up finding his donor in Canada.

But through an international network of more than 33 million potential donors worldwide, he did find a one.

“I found out that my donor was actually a woman from Germany,” he said. “I was more than surprised, but man, I was feeling pretty blessed.”


While on a business trip to Germany last year, Tom met his donor, Doreen. (Submitted by Tom Wong)

Now healthy, Wong is continuing to fight to ensure others can find their match.

“I’m not going to stop. This is dear to me and whatever weakness this created, it kind of made me stronger.”

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Ontario hockey coaches ordered to talk to players about gender diversity

In minor hockey dressing rooms across Ontario this fall, coaches will be delivering a different kind of message.

It won't be focused on power-play strategy or skating fundamentals. Instead, every coach in the province has been mandated to carry out a pre-season chat with players about gender diversity, respect and inclusion.

"We want to make the game inclusive and understand that our coaches' responsibility is not to judge individuals on the face of things, but to create an environment where everyone feels respected and comfortable in a hockey arena," said Phil McKee, executive director of the Ontario Hockey Federation, which oversees hundreds of clubs across the province.

Coaches across Canada receive some training around gender and inclusion as part of a mandatory Respect in Sport course that all coaches must take before stepping behind a bench. But Ontario is the first province to mandate a pre-season chat of this kind.

It's not a move the OHF made entirely voluntarily. Rather, it was part of the settlement of a case brought before the Human Rights Tribunal of Ontario back in 2013. A complaint was brought by Jesse Thompson of Oshawa, Ont., a transgender teen who told the tribunal he was outed when he was asked to use a dressing room that aligned with his gender at birth (female), and not his identified gender (male). The tribunal heard that Thompson wasn't allowed in the boys' room and, at the same time, some parents of female players objected to him using the girls' room.

McKee said the mandatory conversations will be held among teams of all ages, across all levels of competition. As part of the settlement, the OHF will also conduct random audits until at least 80 per cent of organizations under its umbrella have instituted the mandated chats.

McKee said the OHF is providing organizations with detailed checklists to help them navigate what some see as difficult subject matter. He said Hockey Canada reached out to Egale Canada, an LGBT advocacy group, to help guide coaches on matters such as "introductory pronoun check-ins."

"Pre-season chats are a great opportunity for everyone on your team, including coaches, assistant coaches and volunteers, to share the name and gender pronoun by which they wish to be called," Egale said in the package it provides to the OHF to distribute to coaches. "Explain that it is important to ask for and share gender pronouns, just like names, because it is not something you can always tell just by looking at someone. Tell players that it is OK to make mistakes but that it is important to show that they are trying to remember by simply apologizing and correcting themselves if they do slip up."

Coaches are also reminded to discuss a player's rights when it comes to gender identity. "Explain that it is everyone's right to define and express their gender without fear of being discriminated against or harassed," Egale advises. "State that this means that everyone has the right to be referred to by the name and gender pronoun they request and the right to use the washroom or dressing room (or any other gender-specific space) where they feel most comfortable."

Egale has also provided coaches with a detailed glossary, including terms associated with assigned sex (like intersex) and terms associated with gender (like polygender and cisgender).

Mixed reaction

McKee said the initial response from coaches has been mixed.

"Depends on who you talk to. Some people feel like it's just checking a box but other people definitely learned a lot."

David Noon coaches a team of eight-year-olds in Toronto. He agrees with what the OHF is trying to do.

"You have to be respectful to everybody and I think it's important to understand that," Noon said. "You have to make everyone around you feel comfortable and I think that comes from knowledge and understanding people."

However, he doesn't think it's a message coaches should have to deliver. Instead, it should be an opportunity for parents to coach the coach.

"I think to put the onus on the coach is irresponsible. It's not the coach's responsibility. It's the parent's responsibility," Noon said.

"If you are a parent and you want to make your son or daughter comfortable in a situation on a team, it's your responsibility to educate the coach or manager of the the team to create a comfortable environment for your child."

Beyond comfort zones

McKee understands that some coaches and parents may feel uncomfortable with the subject matter, but he said there is little choice.

"We are not asking coaches to deliver sex education here," he said. "We are asking coaches to build an environment of inclusiveness and respect and provide information, an aspect of understanding.

"It's not your job to inform other players and parents that somebody is transgender. It's to provide confidentiality and accommodation."

McKee acknowledges this isn't a widespread issue in hockey or a topic traditionally associated with the game. He said the OHF is currently working with about 60 cases where it is ensuring local clubs are properly accommodating players.

"Is it an overwhelming percentage of our population? No. It is about making people who may feel different feel comfortable, that they can enjoy and live their lives while playing the game of hockey and have fun. And part of that is making people move beyond their comfort zones and hopefully this will help."

He said before this ruling, it wasn't an issue he gave a lot of thought to.

"It gave me a real understanding that everyone is different in their own way," McKee said. "You may dress as a boy, you may dress as a girl. You may dress in a feminine way, you may dress in a masculine way, and that may have nothing to do with who you feel you are as an individual inside or who you are attracted to on the outside."

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Pediatricians, parents guided on gender diversity to help kids grow up 'feeling safe and secure'

New Canadian Paediatric Society guidelines help doctors discuss the complexities of gender identity in children with their parents and caregivers.

An online resource will help pediatricians answer common questions from parents, including explanations about the differences between sex, gender identity, gender expression and sexual orientation.

"More and more, parents are asking us when and how gender identity typically develops in children, what is considered typical behaviour, and what they should expect at certain ages," said CPS president Dr. Mike Dickinson, noting it's common to confuse gender-related terms.

Dickinson said families are increasingly coming to pediatricians with questions and concerns about their children's gender expression and sexual orientation, but not all doctors are well enough informed about the issue to provide answers.

"For a lot of them, this was not something that was necessarily covered while they were in medical school or in their pediatric training, and they are being approached by families and by youth with questions about this," he said from Miramichi, N.B., where he practises.

"So we wanted to put out a primer for our members, but also something that might be helpful to the public at large, informing people about some of the basic issues, some of the basic terms used, with gender identity and gender expression a starting point for people to at least be able to have some discussions around this issue with their patients and their families."

Gender development is often associated with puberty and adolescence, but children begin showing interest in their gender early in life, the CPS says. Although every child is unique and may develop at a different pace, most children have a strong sense of their gender identity by the age of four.

Dr. Michael Dickinson said families are increasingly going to pediatricians with questions and concerns about their children's gender expression and sexual orientation.(Canadian Pediatric Society)

The guidelines outline how gender development evolves, depending on age, and advises parents how to best support their children throughout the process. The resource document also features a list of external resources that may be helpful to parents of transgender and gender-diverse children.

Annie Pullen Sansfacon, co-founder and vice-president of Gender Creative Kids, said having a resource guide for doctors "is really, really good because there are still a lot of families who are struggling with this concept around gender identity and supporting their children.

"And to have [a profession] like pediatricians who are coming out with a statement, I think it's very helpful," said Sansfacon, a professor of social work at the Universite de Montreal.

Supporting children

Dickinson said that as society becomes increasingly accepting of individuals expressing their gender in different ways, there's a tendency for children to be more comfortable coming forward about their own experience at "younger ages than they used to, because they feel that they can and that they can do that safely."

However, discouraging children from expressing a gender can make them feel ashamed, the CPS says.

Particularly during the teenage years, "these are kids who are at risk of being the victims of bullying and also at risk of things like anxiety and depression," Dickinson added.

"The message that we want to send to pediatricians … and to families is that we want the children to feel loved and accepted regardless of their gender identity or their gender expression, and that we want kids to grow up feeling safe and secure, with confidence and self-esteem.

"We want to be able to encourage both parents and I guess society as a whole to be open to the fact that there are these individuals amongst us and often they are our children and our youth," he said, "and they need our love and support and guidance."

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'The Good Doctor' EP Daniel Dae Kim 'Couldn't Be Prouder' of the Show's Diversity

Daniel Dae Kim is a big fan of The Good Doctor, and not just because he’s an executive producer. 

The 49-year-old actor appeared with showrunner David Shore, star Freddie Highmore and the cast of The Good Doctor during the series’ panel at PaleyFest in Los Angeles on Thursday, where he opened up about making diversity a big priority for the show. 

“It’s important to have not only diversity in front of the camera, but behind it. I couldn’t be prouder of the team that I’m working with, because I know that’s important across the board,” Kim said, as the cast noted the show’s representation of race and gender in addition to featuring a doctor on the autism spectrum. “The most important thing is that we make an entertaining show, and we’re doing it with a diverse group of people.” 

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Brian To for the Paley Center

This isn’t the first time Kim has spoken out about diversity. The actor left Hawaii Five-0 along with Grace Park last July, over salary disputes with CBS. Kim and Park had been seeking salary equality with Alex O’Loughlin and Scott Caan. CBS’ final offer to Kim and Park was reportedly 10 to 15 percent lower than the salaries of O’Loughlin and Caan.

“As an Asian American actor, I know first-hand how difficult it is to find opportunities at all, let alone play a well developed, three dimensional character like Chin Ho,” Kim said in a statement at the time. “The path to equality is rarely easy. But I hope you can be excited for the future. I am.”

Kim has definitely found success on the producing side. He helped bring The Good Doctor to life, purchasing the rights to the South Korean version after watching it in 2013. The American adaptation was renewed for a second season earlier this month, with Kim revealing that he’d like to get even more involved with the series in front of the camera in season two.

“I would love to, at some point,” Kim teased. “I’m such a fan of the writing. I’m also such a fan of these actors. As satisfied as I’ve been watching behind the monitors, there’s a part of me as an actor that really wants to play with talented people.” 

“So if there’s the right storyline,” he continued, “I wouldn’t be surprised if I make an appearance sometime.” 

The season finale of The Good Doctor airs Monday at 10 p.m. ET/PT on ABC. 

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Lack of racial diversity in medical textbooks could mean inequity in care, study suggests

Sitting in a doctor’s waiting room in Vancouver, Patricia Louie saw posters that only featured white and light skin-toned people depicted as patients. She wondered if medical textbooks would also reflect what she considered to be a biased portrayal of Canada’s diverse population.

The experience in 2012 led the sociology student who was studying at the University of British Columbia at the time to analyze faces in four textbooks widely used in North American medical schools. She concluded in an honours thesis that racial diversity was being ignored.

Most images in medical books are of legs, arms and chests, showing only skin tone, not race, so Louie broadened her research as a master’s student at the University of Toronto and focused on skin tone in over 4,000 images in later versions of the same textbooks.

The study by Louie and co-author Rima Wilkes, a sociology professor at the University of British Columbia, found the proportion of dark skin tones represented was very small in images featured in Atlas of Human Anatomy, Bates’ Guide to Physical Examinations and History Taking, Clinically Oriented Anatomy and Gray’s Anatomy for Students.

Atlas had fewer than one per cent of photos featuring dark skin, while the highest amount — five per cent — was included in Gray’s, the researchers say in the study, published in the journal Social Science and Medicine.

Imagery of six common cancers for people of colour or dark skin tone hardly exist in the textbooks, says the study, which suggests unequal health care could result.

‘The research shows that even though blacks are less likely to get skin cancer than whites, they’re more likely to die when diagnosed.’– Patricia Louie

“Although we can’t make any causal statements, I think it’s fair to say that the material in textbooks may influence how doctors think about who a patient is and that the under-representation of dark skin-toned people may contribute to inequities in treatment,” said Louie, who is of Caucasian and Asian heritage.

She said mortality rates for some cancers, including breast, cervical, lung, colon and skin, are higher on average for black people, who are often diagnosed at later stages of the disease.

The study draws on research that says 52 per cent of black people receive an initial diagnosis of an advanced stage of skin cancer compared with 16 per cent of white people.

“The research shows that even though blacks are less likely to get skin cancer than whites, they’re more likely to die when diagnosed,” Louie said.

Skin cancer would require doctors to look for melanomas on nails, hands and feet, but none of the textbooks included images of what that would look like in dark-skinned patients, raising questions about whether physicians are adequately trained to treat people of diverse races, she said.

“I would like publishers of medical textbooks to include more images of darker-skinned people and also to pay attention to the way diseases are presented on darker skin tones because that is very necessary for equality of care for racial minorities and darker-skinned people in Canada and the U.S.,” said Louie, who is now doing a PhD in racial inequality in health care.

The study cites data from two U.S. studies that suggest race-based inequities pervade the health-care system in the United States, and black dialysis patients are less likely than their white counterparts to be referred to transplant waiting lists.

Dr. Roger Wong, executive associate dean at the University of B.C.’s faculty of medicine, said valuing diversity should mean promoting it in textbooks.

“So updating future editions is the way to go,” he said of the four books related to the study. “I do think it has flagged for these editors and for writers that all of us need to be very mindful, and I do agree there’s work to be done.”

Beyond textbook learning, Wong said case studies presented at the university’s medical school are rigorously vetted to ensure they reflect Canada’s ethnic diversity and real patients who volunteer to interact with students are selected based on similar guidelines.

“With Indigenous patients, traditional medicine is very important,” he said, citing an example of diversity. “We need to respect and understand where that’s coming from and also understand some of the nuances of when we talk about ‘western medicine.'”

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