Practicing Cultural Humility in the Therapy Space

They existed before colonization tried to erase them.

For centuries, Two-Spirit people have embodied the sacred truth that there are more than two genders. Their existence defies the rigid categories mainstream society tries to impose.

Two-Spirit identities carry profound spiritual and cultural significance across hundreds of Indigenous nations on Turtle Island (what we now call North America). These roles transcended the male/female divide, holding revered spaces as Knowledge Keepers, visionaries, and community leaders.

The violence of colonization brought systemic efforts to extinguish Two-Spirit people and their teachings. The very existence of these identities represented a threat to colonial heteropatriarchal values.

Yet, Two-Spirit people have always been here, their resilience woven into the fabric of their nation’s survival. Now, in an era of reclamation and healing, they are making themselves impossible for the mental health field to ignore any longer.

The question is - are we listening?

Are we truly creating space to provide affirmative, decolonized care that centers Two-Spirit identities, experiences, and teachings?

If not, we risk perpetuating a long legacy of violence and erasure under the guise of “universal” care. It’s time to step up and do better…

What does it mean to be Two-Spirited?

Inclusive 2SLGBTQIA+ flag with Two-Spirit, Intersex, and Métis symbols.

Two-Spirited people are the truth tellers that colonizers tried to bury - sacred beings whose existence transcended the narrow gender binary long before settlers arrived.

Across Indigenous nations, Two-Spirit people embody the divine balance of masculine and feminine spirits. In 1990, the term “Two-Spirit” was coined as a rallying call to reclaim and honour the traditional third-gender roles that colonizers failed to exterminate. More than a label, it signified a cultural renaissance.

Two-Spirit centres concepts of gender and sexuality distinct from the LGBTQ+ experience. It affirms the fluidity that colonization could never contain within rigid boundaries.

To embrace Two-Spirit identities is to shed colonial blinders and make space for the sacred, gender-transcendent truth that existed long before - and will long outlast - attempts to suppress it.

“There’s two great spirits living inside of you. One is a female, one is a male.”

— Ma-Nee Chacaby, Ojibwe Two-Spirit Elder

Exploring the diversity of Two-Spirit identities across different Indigenous nations

The term “Two-Spirit” is an umbrella term that encompasses a wide diversity of gender identities, expressions, and roles across different Indigenous nations on Turtle Island.

While it refers to individuals who embody both masculine and feminine spirits, the specific meanings and traditions around Two-Spirit identities vary greatly between nations and cultures.

Some key points about the diversity of Two-Spirit identities:

Not all Indigenous nations have traditional third-gender or gender-variant roles. The existence and significance of Two-Spirit roles are specific to each nations’ cultural teachings.
The terms used to describe Two-Spirit people differ across languages and nations. For example, the Cree terms napêw iskwêwisêhot (men who dress like women) and iskwêw ka napêwayat (women who dress like women), the Siksika (Blackfoot) term aakíí'skassi, the Ktunaxa term titqattek, and the Zuni term lha'man.
The specific roles, work duties, dress, and lifestyle of Two-Spirit individuals vary between cultures. In some, they served as healers, visionaries, and ceremonial leaders. In others, they took on typical gender roles of the opposite sex.
The connection between Two-Spirit identity and sexuality/gender expression is complex. In certain nations, it primarily refers to gender roles and expression. In others, it encompasses same-sex attraction and relationships.
The spiritual aspect of Two-Spirit identities also differ, with some cultures viewing them as having unique spiritual gifts and roles, while others do not emphasize the spiritual dimension as much.

So while “Two-Spirit” aims to unify Indigenous LGBTQ+ identities under one term, it represents a vast diversity of distinct nation-specific traditions, roles, and cultural understandings of gender and sexuality. The term respects this diversity rather than imposing a single pan-Indigenous definition.

The Trauma of Erasure

The impact of colonization has had a profoundly disruptive and damaging effect on Two-Spirit roles and identities across Indigenous nations.

Colonizers viewed Indigenous concepts of multiple genders and non-binary identities as violating Christian religious values and the patriarchal gender binary. This led to active suppression of Two-Spirit roles through policies like residential schools and assimilation efforts.

Same-gender relationships and gender non-conformity were criminalized by colonial laws. Two-Spirit people faced extreme discrimination, violence, and denial of rights and status within their own nations due to colonial influence.

The relentless stigmatization caused some Two-Spirit people to feel ashamed of their identities and roles. This internalized phobia made it difficult to embrace their Two-Spirit identity openly and pass on teachings.

Residential schools and suppression of Indigenous spirituality disrupted the intergenerational transfer of knowledge about Two-Spirit roles and teachings. This created identity struggles for future generations who were disconnected from their traditions.

The violence, discrimination, shame, and cultural dislocation experienced by Two-Spirit people over generations has created complex intergenerational trauma still impacting mental health and well-being today.

“Being Two-Spirited is like being a pipe carrier or being a lodge keeper: our lives are for the people. When you’re young, you don’t know these things, but as you get older, you learn.”

— Marlon Kazhai, Navajo Two-Spirit person

Two-Spirit people face significant mental health challenges and disparities compared to the general population.

The lasting effects of this colonial oppression include higher rates of depression, anxiety, PTSD, substance abuse, and suicidality among Two-Spirit people. Restoring positive Two-Spirit identities, roles, and community connections is vital for healing from this historical and ongoing discrimination.

Some key points about the mental health needs of Two-Spirit individuals:

DEPRESSION AND ANXIETY
Studies have found higher rates of depression and anxiety among two-spirit people, often linked to experiences of racism, homophobia, transphobia, and the impacts of colonialism and intergenerational trauma.

POST-TRAUMATIC STRESS DISORDER (PTSD)
Two-Spirit people report elevated rates of PTSD, which can stem from traumatic experiences like violence, discrimination, and historical trauma from residential schools.

SUICIDALITY
Research indicates that suicide risk for Two-Spirit people is greater than among the heterosexual Indigenous population which is increased by homophobia, isolation, and rejection.

SUBSTANCE USE
Two-Spirit adults have higher rates of alcohol misuse and illicit drug use compared to heteronormative Indigenous and non-Indigenous populations, often used as coping mechanisms for trauma and minority stress.

Keys to Two-Spirit Affirmative Therapy

Cultural Humility and Ongoing Education
- Commit to ongoing learning about Two-Spirit identities, roles, and teachings across diverse Indigenous nations.
- Approach therapy from a stance of cultural humility, avoiding assumptions and centering the client’s self-definition.
- Learn about colonialism's impacts and contemporary challenges facing Two-Spirit people.
Create a Visibly Inclusive Environment
- Use gender-neutral intake forms allowing self-identification.
- Display artwork/symbols celebrating Two-Spirit identities and Indigenous cultures.
- Provide gender-neutral restrooms and use appropriate pronouns.
- Ensure non-discrimination policies are visibly posted.
Integrate Indigenous Healing Practices
- With consent, incorporate traditional healing methods like smudging, talking circles, etc.
- Collaborate with Indigenous Elders or Knowledge Keepers when appropriate.
- Allow space for exploring Indigenous teachings on Two-Spirit roles.
Understand Intersectional Identities
- Recognize how Two-Spirit identity intersects with Indigeneity, gender, sexuality, and spirituality.
- Explore the impacts of multi-layered oppression (racism, transphobia, homophobia).
- Validate strengths stemming from intersectional identities.
Build Community Connections
- Provide referrals to Two-Spirit community groups, events, and mentors.
- Encourage clients to explore Two-Spirit histories and reclaim pride.
- Support the development of chosen family and support systems.
Advocate for Systemic Changes
- Advocate for more Two-Spirit representation in mental health leadership.
- Work to increase access to culturally competent, gender-affirming services.

By centering cultural humility, creating inclusive spaces, exploring intersectionality, and advocating for systemic changes, therapists can provide affirmative care while dismantling barriers faced by two-spirit clients in accessing competent mental health support.

Answering the Call for Increased Inclusivity

Ultimately, it's a call to become true allies and advocates - championing Two-Spirit pride, resilience, and access to affirmative care at all levels. To honour the reclamation of these sacred roles that colonizers could never fully extinguish.

The Two-Spirit identity movement represents a cultural renaissance and restoration of balance. As mental health providers, we must answer that rallying call. We must open ourselves to the gender-transcendent truth that has always existed if only we're willing to see it.

The path forward lies in decolonizing our practices, centering Two-Spirit voices, and taking action to dismantle systemic barriers to inclusive care.

The Two-Spirit teachings we've been denied for too long await us. It's time we make space to listen, learn and embrace the healing that comes with affirming these sacred, timeless identities.

If You Need Support

For any Two-Spirit or LGBTQ+ individuals reading this who are struggling, please know you are seen, valued, and deserving of affirmative care. Your identities are sacred.

If you or someone you know is experiencing a crisis, there is help available:

LGBTQ Crisis Support Hotlines:

The Trevor Project Lifeline: 1-866-488-7386
Trans Lifeline: 1-877-330-6366
LGBT National Hotline: 1-888-843-4564

Indigenous Support Services:

National Indigenous Crisis Line: 1-800-588-8795
Native Youth Crisis Hotline: 1-877-209-1266
Two-Spirit Support Line: 1-855-554-4325

You can also reach out to local LGBTQ+ and Indigenous community centers, counselling services at colleges/universities, or PFLAG chapters for support groups and affirming resources.

We offer 2SLGBTQ+ Affirming Care here at Cherry Tree Counselling and are ready to support you. Get started today.

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SOURCES:

National Collaborating Centre for Aboriginal Health An Introduction to the Health of Two-Spirit People: Historical, contemporary and emergent issues

APA PsychNet “Recent insights into the mental health needs of two-spirit people.”

Canadian Museum for Human Rights What is Two-Spirit? Part One: Origins

Native Women’s Association of Canada Intersections: Indigenous and 2SLGBTQQIA+ Identities

OACAS Library Guides “2SLGBTQ+ identities and child welfare.”

QMUNITY “Mental Health in Queer, Trans and Two-Spirit Communities: Why Are We More Greatly Impacted?”

The Human Condition “Affirmative therapy: History, benefits, and effectiveness.”

The Indigenous Foundation “The History of Two-Spirit Folks.”

TVO Today “‘You belong in this world’: Two-Spirit survivors share their stories.”