Why we need to transform health-care systems to reflect the communities they serve

Who am I?

As a 50+-year-old who lives in the borderlands of multiple identities, this is a familiar question, one that I’ve heard since grade school.

The conversation goes something like this:

“Wow. What are you? You look different; something exotic or something. Where are you from?” Here.
“No, like really from. Where are your people from?” Here.
“Your grandparents? Your grandparents’ parents?” All were born here.

Usually they become frustrated with my answers, like I’m somehow trying to trick them, but it generally ends with “But what are you? You’re not White, or not really.” The conversation often includes people – young and old touching my hair accompanied by comments “well, at least you have good hair.” Unfortunately, we live in an oppositional world, thus if there is good, there must be bad. It’s as clear as Black and White.

“But what are you?”

It’s the “what are you” and hair comments that grated on my heart. “What” like an object or animal, but not human, nor female or woman? Growing up in London, Ontario, my family was one of three Black families, so everyone knew each other, and I never questioned who I was, nor where I belonged. I fit perfectly with the rest of my community of generational Black Canadians, who were the descendants of escaped and freed slaves. There were many names to describe our communities, all of which were hinged on the shade of our skin. We were not strangers to hate or exclusion. Most of us were too light skinned to be included in the influx of Caribbean newcomers that began in the ‘60s by the Canadian foreign employment program, which brought Caribbean women here to be nurses and domestic workers, but we were too dark skinned to fit in with White settlers we had resided with, or beside, for decades.

Let me introduce you to my social-political identity, which has become “who I am”, yet fails to cherish how I became the me I am today. I am Tina Garnett, known as Tee by most. I’m a sixth generation Canadian Black Queer non-binary middle-aged person with physical and mental health differences that make access, mobility and learning processing different than so-called “normal” folks. I remember when my therapist told me that “normal” is a dryer setting, otherwise there is no such thing as normal.

Growing up on the outside provided me with the opportunity to witness the mechanics of how Canadian systems, including health-care systems, were developed and continue to operate. These systems were built with an affinity for those that resemble the original creators/settlers, while simultaneously oppressing, repressing, and depressing those reflecting the opposite of the settlers. Unfortunately, living in this binary opposition of an either/or mentality is no longer working for most of us, but it’s hard to know what you don’t know – let alone admit it and know how to change it.

That’s why I do what I do.

As SickKids’ first Executive Lead and Strategic Advisor, Equity, Diversity and Inclusion (EDI), I support folks in learning the truth about the institutionalization of discrimination and how to be better by creating safe spaces for each of us to bring our full selves into the conversations and feel fully seen, heard and valued.

Being diverse from the status quo has never been an issue until it impacted my safety, which it often has, particularly when my cute little Black boys became (handsome) tall Black men and fathers. Safety becomes concerning when engaging with systems that were not historically created to include or reflect people who look different than those for whom it was created.

I’ve been leading equity and inclusion conversations for over 25 years, and this new role at SickKids, beyond the title, provides me with the autonomy and authority to create spaces to lead the critical conversations that are necessary for transformational equity to exist.

As the first Black queer female/non-binary executive at SickKids, I am at the tables where the conversations are happening about the future of our children’s health care. It sends the message that change is possible and is happening now.

People feel good about working in a place where they can see themselves throughout the organization; when a patient can see themselves and their community reflected in the health-care workers supporting their care. Families feel safer when they can see themselves reflected in staff and leaders of the hospital they walk into and feel included when they’re authentically reflected in promotional materials for the hospital.

Our community is also changing quickly and dramatically. By 2031, all baby boomers will be eligible to retire; in that same time racialized community members will become 51 per cent of the city’s population. These demographic changes will impact SickKids’ future and how we provide the best care possible. We must be proactive in creating equitable and inclusive services for our diverse communities now.

Diversity brings creative solutions and opportunities. As part of my role, I plan to create a robust EDI action plan not just because it’s the right thing to do, but because it’s the smart thing to do. My education is focused on the ingenuity and codependency of economic growth and how systemic discrimination has been socialized as a normal part of our society. People think learning about EDI is an adjunct to clinical learning, when in fact it’s a specialized discipline to understand the global indoctrination of discrimination in our socio-political systems, including in health care.

Change is not easy, and it may cause folks to feel uncomfortable, not knowing or understanding how these changes will impact them. Unfortunately, many of us are unaware of our privilege, until it’s been challenged. Everyone who enters the doors of SickKids, patients or staff, all want to feel seen, valued and heard, thus EDI is about how to do that for each of us.