The findings of the gay health project gave rise to an awareness-raising campaign among the health authorities and the establishment of on-going cooperation with public and private partners in order to reduce the adverse impact of social health determinants such as homophobia and heterosexism and to take action to prevent suicide in particular. More broadly, efforts around health contributed to efforts to prevent homophobia in schools and offer support to victims of assaults. These findings then led to the development of Le Refuge Project in Dialogai.
Health authorities and Health Care Providers
The fact that gay men visit health care providers frequently and yet are often in poor health points to communication and trust issues between caretakers and care-receivers and leads to the suspicionsuggests they are not receiving proper care.
There must be awareness-raising and specific training modules for health care professionals on LGBT health. Communication techniques to make it easier to reveal one’s sexual orientation and gender identity are absolutely vital to improve the health of LGBT people. Multiple actions in this regard have been carried out by Dialogai partners. A more elaborate training project is underway for French-speaking LGBT organizations in Switzerland.
Consultation-ordinating with and information fromreporting to cantonal and national health authorities are imperative for the gay health project. Since Having signeding a service provision contract with the Canton of Geneva and as a member of the Federal Strategic Group on Sexual Health,. Dialogai regularly reports findings from its research and projects to these bodies. In Geneva, the authorities quickly became aware of the importance of other health problems beyond AIDS and ISTs for the gay community. The authorities supported development of the Blues-Out project through the Geneva Alliance against Depression. These latest service provision contracts signed by Dialogai byand the Canton of Geneva include the launching of a health promotion campaign focused on mental health. In the federal arena, the shift from a sexual -health- based vision to an overall health focus for LGBT people is still underway. The report on mental health in Switzerland and the suicide prevention action plan were just validated and the implementation of these strategies started in 2017. Checkpoints in Switzerland are still primarily focused on sexual health and have not yet developed an overall health strategy. LGBT health still remains to be dealt with has yet to be tackled and those who shwould be in charge of this haves yet to be defintermined. All of these uncertainties mean that important issues such as training of health care providers around LGBT health issues have still not been resolved. There have been local-level initiatives, however, carried out by LGBT associations.
Finally, the issue of regular, quality data collection on LGBT health and the analysis of this data also remains unresolved. Despite multiple attempts, the Swiss Health Survey (ESS) still does not include any questions about sexual orientation or gender identity addressed to all participants.
Training and awareness-raising for education and students
Many researchers have showned the negative health impact of thethat stigmatization of and violence thathas on many LGBT people face in school. The gay health project studies confirmed this. Regarding mental health, a great number of young LGBT people suffer from anxiety and depressive symptoms even before they are realize they are gay. These types of stress, during the fragile period of adolescence, often lead to risky behaviors and suicide risks.
After the Meetings against Homophobia in eEducation in 2009, organized by the Geneva LGBT Associations Federation in 2009, homophobic discrimination wasere the target of atargeted under a prevention program for Geneva and Vaud-area schools. Dialogai regularly takes part in awareness-raising efforts for students and teachers and continuing education courses for teachers and education professionals along with the Geneva LGBT Association Federations. In tTThese interventions, activities regularly address the impact of homophobia and heterosexism on young LGBT individuals is regularly addressed.
While considerable progress has been made over the past few years, there is still much work to be done. Most educators still receive no training on these issues and are unaware of how to react when they see homophobic acts. Raising awareness among students about sexual and gender diversity still depends on the good will of school principals. While on-site interventions have regularly taken place at the post-mandatory secondary-school level, this is not the case when it comes to mandatory secondary school despite the fact that most accounttestimonies point to this as the time where homophobia is most prevalent and damaging for students’ future development.
Suicide prevention and care for at-risk individuals
Since findings on suicidality from the 2002 survey were published, Dialogai has partnered with the Stop Suicide association which is in charge of youth suicide prevention in French-speaking Switzerland. For some years now, Stop Suicide has been the only suicide prevention organization to recognize LGBT people as an at-risk population. The national press conference held by Dialogai in February 2013 on the findings of 3 Swiss surveys on suicidality had a major national media and political impact. Some of the measures taken included prioritizing LGBTs as a target group in the suicide prevention program for the Canton of Zurich and including LGBT people as a target group in the 2016 suicide prevention plan for the first time. In Geneva, Dialogai has also been a member of the social-health network aiRedados since it was created by Malatavie, the crisis unit in the Geneva University Hospital in 2013 in order to improve care given to young people at risk of suicide. As part of this network, Dialogai partners actively to implement training to recognize signs of suicide risk, suicide prevention and professional practice analysis modules. Finally, as part of its Le Refuge Project, Dialogai pays special attention to suicide prevention. These efforts should be systematically taken into account when implementing the national suicide prevention plan.
Prevention and support for gay bashing victims
Our surveys show that gay men are 3 to 4 times more often victims of violence than men in the general population and that this violence did not go down between 2007 and 2011.
Given the recurrence of gay bashing on the street and regular complaints from victims and witnesses about the quality of the police response, Dialogai has set up a working group to dialogue with the Geneva Police on these complaints and propose specific solutions in order to prevent assaults and provide care for victims. Founded in 2013, this working group brings together representatives from the cantonal and municipal police of Geneva, the Geneva City official in charge of LGBT issues, a person working on a Law to Aid Victims of Violence (LAVI, the French acronym), grassroots figureentities such as Aspasie, Dialogai and the Geneva AIDS Group as well as gay-bashing victims themselves. The goal of this working group is to create trusting relationships between the police and gay-bashing victims and reduce the occurrence of these acts through prevention and informationreporting efforts on the ground. The first findings of these efforts werehave been positive and according to victims of serious gay bashings in 2016, reception given at police stations in Geneva has improved.