Submission to the Standing Committee on Health
Women’s Health Study
November 2023
The Canadian Association of Social Workers (CASW) welcomes the opportunity to submit to the Standing Committee on Health’s study of Women’s Health. We would like to acknowledge that the Standing Committee on Health is comprised of 11 male members out of a total of 12. Despite efforts to enhance female representation through seat exchanges among members, it is disconcerting that the committee does not align with the gender parity goals of our government. We strongly encourage Members of Parliament across all political affiliations to prioritize gender parity in the selection of committee members, thus preventing any backslide in our collective efforts.
Summary of Recommendations:
- Address the long-standing health inequities faced by marginalized and vulnerable women.
- Collaborate with provincial and territorial governments in creating a strategy to improve senior women’s health in Canada.
- Establish protected policies and provisions that will not only support victims of gender-based violence but also prevent those from becoming victims in the first place.
- Collaborate with provinces and territories in ensuring equitable access to abortion care.
- Protect the interest and rights of LGBTQ+ Canadians by working with provincial and territorial governments to improve access to gender affirming care.
Marginalized and Vulnerable Women
The CASW calls on the federal government to address the long-standing health inequities faced by marginalized and vulnerable women.
Indigenous and racialized women, women who live in rural and Northern communities, women fleeing violence, newcomers, single mothers, LGBTQ+ women, low-income women, and women with disabilities often face barriers in health care. Caught in the intersection of gender and social categorizations such as race and class, these women are placed at an even greater disadvantage.
In Canada, marginalized and vulnerable women face challenges including inadequate access to health care, high rates of chronic disease and mental health issues and discrimination.[1],[2],[3]
Senior Women
The CASW calls on the federal government to work with provincial and territorial governments in creating a strategy to improve senior women’s health in Canada.
Senior women in Canada face unique health challenges. As our population ages, it becomes even more essential that the specific needs of senior women living in Canada are addressed. After turning 65, women often experience life in an unhealthier state when compared to men (30.9% and 27.7% respectively).[4]
Senior women grapple with several different chronic health conditions at a higher rate than men. This includes osteoporosis, rheumatoid arthritis, dementia, asthma and osteoarthritis.4
During the pandemic, senior women were twice as likely to report depressive symptoms compared to men, underscoring the benefits of mental health support.[5] The occurrence of poor mental in senior women was prevalent before the pandemic and still is an issue today.
Among senior women who are immigrants to Canada, there is a significantly higher chance of experiencing loneliness which can lead to negative mental health. The high risk of loneliness can be attributed to the cumulative effect of family transitions, lack of adequate social relationships, economic hardships and the burden of caretaking of a spouse.[6]
Gender Based Violence in Canada
CASW strives for a Canada free from gender-based violence and oppression. That is why we continue to demand a Canada in which our laws, policies and procedures support, empower, and protect the dignity and safety of women and girls.
Gender-based violence is the most common abuse inflicted upon women, girls, and Two-Spirit, trans and non-binary people. Some are at an even higher risk of being abused due to the additional discrimination and barriers they face. This includes women with disabilities, Indigenous women, racialized women, trans and non-binary people, and women who are homeless or underhoused.
In 2022, 184 women and girls were violently killed, with more than 4 in 10 women reporting some form of intimate partner violence in their lifetimes.[7],[8] In a Justice Canada 2009 report, addressing the aftermath of spousal violence was estimated to cost $7.4 billion.[9]
The role of social workers in addressing gender-based violence is to provide the needed services to the victims through psycho-social support. This could be done by moving the victim to a shelter, providing support at court, and trauma debriefing. Canadian social workers affirm the lived experiences of women and stand in solidarity with victims and survivors of violence.
However, social workers cannot perform their duties effectively when the needed resources are not available. That is why the Canadian Association of Social Workers calls on the federal government to protect those most vulnerable to gender-based violence by putting in place supportive policies and provisions that will not only support victims but also prevent those from becoming victims in the first place.
CASW welcomes the progress being made on the National Action Plan to End Gender-based Violence as well as the bilateral agreements with provinces and territories. CASW encourages the federal government to continue this important initiative and to establish a dedicated Secretariat.
Reproductive Justice & Access to Abortions
CASW calls on the federal government to collaborate with provinces and territories in ensuring equitable access to abortion care.
The recent decision by the U.S. Supreme Court to overturn Roe v. Wade has renewed concerns about abortion access, even in countries with liberal abortion laws such as Canada. While Canada boasts decriminalization and the absence of legal restrictions like parental consent or waiting periods, there exist significant impediments to accessing abortion services.
In Canada, there are no specific laws restricting abortions, having decriminalized the procedure in 1988. Since then, a growing number of variable provincial and territorial policies have been introduced to enhance access to abortion services. Despite this, the organization of Canada’s health care system and the presence of societal stigma pose significant barriers to access, which must be addressed through bold leadership and policy change at the federal level.
- Geographic barriers: Abortion clinics in Canada are primarily concentrated along the U.S. border, causing considerable inconvenience for rural and remote populations, with Indigenous communities disproportionately affected. For instance, a study conducted in 2013 revealed that one in five women had to travel over 100 kilometres to access abortion services.[10]
- Scope of care: Abortion services are unevenly distributed across Canada, with some regions only providing services up to 12 weeks of pregnancy. Access to abortions beyond the first trimester becomes increasingly scarce, and providers performing abortions beyond 19 weeks are exceptionally limited.[11]
- Insurance coverage and portability: Not all provinces and territories offer abortion care for pregnancies up to 20 weeks. Additionally, abortion remains one of only 16 procedures not considered ‘portable’ under the Canada Health Act.8
At the outset, it must be acknowledged that the abortion dialogue is intertwined with broader conversations on reproductive rights and reproductive justice. These conversations encompass sexuality, gender, and identity; contraceptive access; the social determinants of health (including the question of free choice regarding whether to carry and/or parent a child in a low-resource environment), and medical and legal institutions that have propped up racism, colonialism, and misogyny.
Gender Affirming Care
CASW calls on the federal government to protect the interest and rights of LGBTQ+ Canadians by working with provincial and territorial governments to improve access to gender affirming care.
Gender-affirming care is described as any form of health care or social support that supports individuals in achieving healthy gender identity development and can include a wide variety of services ranging from mental health counselling to Hormone Replacement Therapy (HRT). In Canada, the demand for gender-affirming care is becoming more common among gender-diverse youth. Minimally invasive cosmetic procedures (e.g., injectable fillers, neuromodulators, laser hair removal) are commonly sought out treatments, and are said to help compensate for delays in accessing more permanent surgical and medical gender-affirming care (e.g., top and bottom surgery); and are thus useful for supporting gender transition in a timely fashion.
Barriers to gender affirming care in Canada include lack of access and harmful new policies. Despite growing demand, there is a lack of local access to minimally invasive gender-affirming care. In the last five years, more than half of trans people with a primary care provider in Canada have identified as having unmet needs. Federal and provincial governments have been slow to address these gaps in trans health and safety.[12] In addition, transphobic sentiments and policy changes at all levels of government are putting trans and gender-diverse youth at risk of mental health challenges and unstable gender development.
About CASW
The Canadian Association of Social Workers (CASW) is the national professional association for social work in Canada. Founded in 1926, CASW is a national federation composed of 10 partner organizations in the provinces and territories.
[1] Srugo, Sebastian A., et al. “Disparities in Primary and Emergency Health Care among ‘off-Reserve’ Indigenous Females Compared with Non-Indigenous Females Aged 15–55 Years in Canada.” CMAJ, 28 Aug. 2023, www.cmaj.ca/content/195/33/E1097.
[2] Comeau, Dominique, et al. “Review of Current 2SLGBTQIA+ Inequities in the Canadian Health Care System.” Frontiers, Frontiers, 3 July 2023, www.frontiersin.org/articles/10.3389/fpubh.2023.1183284/full#:~:text=Ind...(4).
[3] Lane, Ginny, et al. “Chronic health disparities among refugee and immigrant children in Canada.” Applied Physiology, Nutrition, and Metabolism, vol. 43, no. 10, 2018, pp. 1043–1058, https://doi.org/10.1139/apnm-2017-0407.
[4] Public Health Agency of Canada, Aging and chronic diseases: A profile of Canadian seniors. https://www.canada.ca/en/public-health/services/publications/diseases-co...
[5] Reppas-Rindlisbacher, Christina et al. “Gender Differences in Mental Health Symptoms Among Canadian Older Adults During the COVID-19 Pandemic: a Cross-Sectional Survey.” Canadian geriatrics journal : CGJ vol. 25,1 49-56. 2 Mar. 2022, doi:10.5770/cgj.25.532
[6] Islam, MD Kamrul and Gilmour, Heather. Immigrant status and loneliness among older Canadians. https://www.doi.org/10.25318/82-003-x202300700001-eng
[7] Canadian Femicide Observatory for Justice and Accountability, #CallItFemicide: Understanding Sex/Gender-Related Killings of Women and Girls in Canada, 2018-2022. https://femicideincanada.ca/callitfemicide2018-2022.pdf
[8] Statistics Canada. Intimate Partner Violence in Canada, 2018. www150.statcan.gc.ca/n1/daily-quotidien/210426/dq210426b-eng.htm.
[9] Government of Canada, Department of Justice. An Estimation of the Economic Impact of Spousal Violence in Canada, 2009. www.justice.gc.ca/eng/rp-pr/cj-jp/fv-vf/rr12_7/p0.html#:~:text=Spousal%2....
[10] Schummers, Laura, and Wendy V Norman. “Abortion services in Canada: access and safety.” CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne vol. 191,19 (2019): E517-E518. doi:10.1503/cmaj.190477
[11] “Trends in Barriers to Abortion Care.” Action Canada for Sexual Health and Rights, www.actioncanadashr.org/resources/reports-analysis/2022-12-14-trends-bar....
[12] Ross, Katie, and Sarah Fraser. “Minimally Invasive Procedures in Gender-Affirming Care: The Case for Public Funding across Canada.” CMAJ, CMAJ, 14 Aug. 2023, www.cmaj.ca/content/195/31/E1041.