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Virtual Series – Women Veterans' Forum Update and LGBTQ2+ Veterans Roundtable

Context

In 2020 Veterans Affairs Canada hosted a series of 4 virtual events focused on Women and LGBTQ2+ Veterans. These events provided an opportunity for Veterans Affairs Canada to continue the dialogue from the first Women Veterans Forum held in May 2019.

The four event series included three panel discussions as well as a roundtable and included panelists from Veterans Affairs Canada, Women and Gender Equality Canada and the Canadian Armed Forces/Department of National Defence. The series provided Veterans Affairs Canada an opportunity to inform stakeholders how the department is moving forward using Gender Based Analysis Plus (GBA+) lens in relation to the research, services and program initiatives that specifically impact women Veterans. The LGBTQ2+ Veteran Roundtable enabled Veterans and stakeholders from the LGBTQ2+ community to share their experiences and perspectives with senior officials from Veterans Affairs Canada and the Canadian Armed Forces.

Throughout the series, viewers were encouraged to share their experience and ask questions. The questions that are included were provided by the viewers of the series. The following links also provide information on topics referenced during the series:

Questions and Answers

  • Section 1 - Analysis and terminology

    • 1. What are the outcomes that Veterans Affairs Canada is anticipating with these conversations?

      Veterans Affairs Canada is anticipating multiple outcomes with these conversations, including accountablility, awareness and dialogue. An accountability to report back on what the department has been doing since the first Womens Veterans Forum in 2019. An enhanced awareness of Gender-based Analysis Plus (GBA+) and intersectionality which is foundational to all areas of work within the Government of Canada. An alignment with Department of National Defence and Canadian Armed Forces in terms of common areas of interest concerning women and LGBTQ2+ members and Veterans. The initiatation of a dialogue with under-represented sub-groups of Veterans and stakeholder groups to begin to address barriers that may contribute to inequitable access and/or benefits from Veterans Affairs Canada programs and services and an expansion of our outreach beyond existing clients to the broader Veteran population.

    • 2. How can sex and gender-based analysis as well as a feminist-informed intersectional analysis impact and improve the lives of Canadian women and Canadian LGBTQ2+ Veterans?

      A feminist approach challenges the barriers faced by women and LGBTQ2+ Veterans and recognizes that inequalities exist along intersectional lines.

      Government policy is changing how we do things. Underrepresented groups of Veterans are powerful agents of change. Veterans Affairs Canada is proud to have hosted the first ever Women Veterans Forum in May 2019 and followed with the creation of a dedicated Office of Women and LGBTQ2 Veterans in July 2019. Initiatives such as this, as well as the Virtual Series panels in August/September 2020 and LGBTQ2+ Roundtable in October 2020 is all part of the Department’s commitment to cultural change and to take action on gender equality to improve the lives of these Veterans.

      When we invest in underrepresented groups of Veterans such as women and LGBTQ2+ Veterans, everybody benefits. When everyone has equitable access to benefits and services, they not only improve their own lives, but those of their families and entire communities.

    • 3. Quite unique to the military/veteran world "marital status" is a very important intersectionality issue that impacts experiences and their status, rights, outcomes and opportunities. How can "marital status" be officially added onto the Canadian Armed Forces/Department of National Defence/Veterans Affairs Canada Gender-based Analysis Plus (GBA+) recognized intersectionality lens?

      The relevance of marital status in the studies conducted by Director General Military Personnel Research and Analysis is considered from the start, i.e. when formulating the research question and determining the methodologies for the respective studies. Given its potential impact on different groups of Canadian Armed Forces/Department of National Defence members, the majority of the surveys conducted by Director General Military Personnel Research and Analysis involving of Canadian Armed Forces members include a question on marital status. Marital status is also considered through the application of a GBA+ lens applied by the Social Science Research Review Board when reviewing social science research projects submitted to the Board. The importance of the “marital status” intersectionality issue could be further highlighted as we integrate the Sex and Gender Equity in Research (SAGER) guidelines with the GBA+ requirements into the guidelines for DGMPRA research.

      Veterans Affairs Canada must ensure that a GBA+ lens is undertaken with all Budget Proposals, Memorandums to Cabinet, Treasury Board Submissions and Regulatory Packages. VAC is required to identify the Target Group and this includes individuals of particular familial characteristics (e.g. marital status, family status). As well, all proposals must be assessed in relation to the expected outcomes, that is, the direct, indirect and unintended/hidden impacts. This includes demographic factors such as socio-economic, cultural and familial characteristics which includes single person households, two person households, parents (lone parent households and two parent households), as well as other household types which can be specified.

    • 4. Does Veterans Affairs Canada specifically include "marital status" as a point of Gender-based Analysis Plus (GBA+) intersectionality?

      An intersectional lens supports the addressing of inequalities, and it looks at many factors to raise awareness and ensure rights for individuals and their children regardless of marital status.

      Gender-based Analysis Plus (GBA+) is an analytical process used to assess how diverse groups of women, men, and gender diverse people may experience policies, programs and initiatives. We all have multiple characteristics that intersect and contribute to who we are.Gender-based Analysis Plus (GBA+)considers many identity factors and how the interaction between these factors influences the way we might experience government policies, services and initiatives.

      It is an analytical process designed to help us ask questions, challenge assumptions and identify potential impacts.

      Once an issue has undergone the Gender-based Analysis Plus (GBA+) process, one identity factor may emerge as the most important factor, while in other cases it might be any or a combination of factors and their intersection that influence a person’s experience of a government policy, program or initiative.

      The Canadian Human Rights Act ensures that Canadians cannot be discriminated against by institutions or individuals and prohibits discrimination on identified grounds, including race, national or ethnic origin, color, religion, age, sex, sexual orientation, marital status, family status, disability, or conviction for an offence for which a pardon has been granted.

    • 5. Is the Canadian Armed Forces and Veterans Affairs Canada considering broadening their understanding and definition of “Family” to align with a Canadian Armed Forces member’s understanding of their family and to align with family function rather than bloodline?

      The Canadian Armed Forces currently does not have a definition of “family” that is used universally. Under public benefits, those that are approved by Treasury Board, some definitions of who are considered family must follow Treasury Board guidelines and approvals. Under Canadian Forces Morale and Welfare Services, Military Family Services uses a very broad definition of family to align with the member’s understanding of their family. We recognize the important role families have in enabling the operational readiness of the Canadian Armed Forces. We respect that military and Veteran families come in all forms and self-define to include anyone of significance to the CAF personnel or the Veteran. Under the Veterans Family Program, administered by Military Family Services, and paid for by Veterans Affairs Canada, Canadian Forces Morale and Welfare Services uses this broader definition of family to provide support to medically releasing members and their families.

      Veterans Affairs Canada recognizes the vitally important role of families in the care and well-being of our Veterans. Veterans Affairs Canada is working with our research partners and collaborating with the Canadian Armed Forces to develop a Strategic Family Research Program. The working group aims to address current research gaps and identify the way forward on new research directions in the domain of military families.

      In some cases, Veterans Affairs Canada and its partners offer benefits and services to those who care for Veterans, extending beyond traditional family relationships. For example, the Military Family Resource Centres considers family as anyone identified by the Veteran as a key support. Veterans Affairs Canada’s Caregiver Recognition Benefit acknowledges the role that informal caregivers play in providing and coordinating ongoing care for Veterans. Eligibility for this tax free, monthly benefit extends beyond family members and is paid directly to the informal caregiver designated by the Veteran. Veterans Affairs Canada also provides support for a range of mental health services through the Veterans Affairs Canada Assistance Service. Veterans, former RCMP members, their families and caregivers can access mental health services at no cost 24-hours a day, 365 days a year.

      Veterans will have the option to self-identify on the Statistics Canada 2021 Census, which will also ask questions about sex, gender, age, ethnicity, Indigenous status, religion, and languages. This will allow Veterans Affairs Canada to develop a detailed picture of the diversity and intersectionality of the Veteran and family population with the goal of enhancing the delivery of benefits and services that reflect the needs of Veterans and those who support them.

    • 6. Why is ‘women’ applied to certain terminology, but the same does not occur when referring to “men”for example ‘women Veterans’?

      We are continuously reviewing, studying and testing how we communicate with Veterans. This happens through many different processes including courses, user testing and focus group testing to name a few. Using methods like these help us to communicate better with our audience. We will look into testing this terminology to see what the findings tell us and adjust as needed.

      Using gender-inclusive language means speaking and writing in a way that does not discriminate against a particular sex, social gender or gender identity, and does not perpetuate gender stereotypes. Given the key role of language in shaping cultural and social attitudes, using gender-inclusive language is a powerful way to promote gender equality and eradicate gender bias.

      Gender neutrality is important when communicating with people because it is more accurate and is consistent with the values of equality recognized in the Canadian Charter of Rights and Freedoms.

    • 7. How were the Veterans Affairs Canada Women Veterans panel members selected?

      The themes of the event were determined in consultation with the Women Veterans Forum Steering Committee and the Office of Women and LGBTQ2 Veterans. The objectives of the series was to update Veterans on the progress made since the 2019 Women Veterans Forum and identify the key issues/priorities to work toward for equitable outcomes for all women Veterans.

      With these objectives, the topics of initiatives, research, and policy and service delivery concerning Women and LGBTQ2+ Veterans were determined. Panelists who were able to speak to these topics as subject matter experts within Veterans Affairs Canada, Women and Gender Equality Canada and the Canadian Armed Forces/Department of National Defence were selected. Panel members were selected in consultation with the Office of Women and LGBTQ2 Veterans and the Steering Committee.

  • Section 2 - Office of Women and LGBTQ2 Veterans

    • 8. What is Veterans Affairs Canada’s perspective on the unique challenges faced by women and gender diverse Veterans?

      One measure of gender equality and other forms of equality is comparable outcomes, such as wage parity or similar prevalence of health conditions. Based on preliminary analysis of Departmental, governmental, and peer-reviewed research, Canadian Veterans are not all enjoying comparable levels of well-being, which suggests that the Department is not fully meeting its obligation to ensure equality for Veterans.

      While a majority of Veterans make a smooth transition from military to civilian life, many women and LGBTQ2+ Veterans are not doing as well as other Veterans. For example, women Veterans are more likely than their male peers to be released from service for medical reasons and they report greater difficulty in adjusting to civilian life, including securing appropriate, stable employment and income. Women Veterans may face more challenges than men Veterans because they are more likely to be single, lone parents, and/or providing care for aging or ill relatives, all of which can contribute to social isolation and exclusion as well as logistical challenges in managing appointments, arranging for transportation, and locating safe and affordable child or dependent care. Women Veterans also have higher rates of mental illness and suicide ideation, which could be partially related to a greater likelihood of reporting sexual trauma during military service. Researchers have also linked sexual trauma related to military service with risky sexual behaviors, disordered eating, and substance abuse, all of which have negative implications for both physical and mental health. Military service may also differentially affect the physical health of women Veterans in other ways. They are, for example, more likely than men Veterans to report chronic pain as well as mobility challenges and a greater need for assistance with activities of daily living. Women Veterans also have reproductive and sexual health challenges and health needs that are distinct from those of men Veterans and civilian women.

      Research with LGBTQ2+ Veterans is more limited, but available evidence suggests that these Veterans are also not doing as well as some others. We know, for example, that in the past LGBTQ2+ military personnel were driven out of service by and through prejudice and discrimination. It would not be surprising to find that these Veterans have experienced a difficult transition to civilian life, including potential risk of financial instability and employment challenges. Emerging research also points to poorer physical and mental health among LGBTQ2+ Veterans as compared with other Veterans and civilian populations. Studies with civilian populations of LGBTQ2+ people have identified unique challenges related to health, in general, as well as to healthy aging, including finding and securing access to safe, sensitive, and appropriate health and long-term care. LGBTQ2+ Veterans are likely to face many of these same challenges. Research on homelessness among civilian LGBTQ2+ people likewise has found they are at greater risk of violence and/or being refused service or placed inappropriately in shelters.

    • 9. As a Government of Canada department, Veterans Affairs Canada follows Gender-based Analysis Plus (GBA+) and acknowledges the importance of intersectionality. As such, why did Veterans Affairs Canada set up an Office of Women and LGBTQ2 and not an office of equity/equality/inclusion that includes the needs and issues of all marginalized Veterans including Indigenous Veterans and Veterans with racialized experiences?

      The Government of Canada is committed to advancing LGBTQ2+ inclusion and has taken numerous steps including amending the Canadian Human Rights Act and the Criminal Code to protect Canadians from discrimination and hate crimes based on gender identity and gender expression and to affirm their equal status in Canadian society.

      Veterans Affairs Canada created the Office of Women and LGBTQ2 Veterans in July 2019 in response to concerns raised by women and other under-represented groups of Veterans, and to contribute to key federal government commitments to advance gender equality, diversity and inclusion.

      The Office of Women and LGBTQ2 Veterans has been stood up in recognition of the commitment to advancing inclusion for both Women and LGBTQ2+ Veterans addressing issues of this under-represented group.

      Women and LGBTQ2+ service members have represented Canada in uniform for more than a century. Women currently make up 15 percent of the Canadian Armed Forces, and this percentage is expected to increase in the coming years.

      There is overlap within and across the groups represented by the Office. Identity factors like biological sex, socio-cultural gender identity and sexual orientation overlap with other factors such as age, race, ethnicity, socio-economic status, ability, etc. As a result of their experiences and the nature of their identity factors, each Veteran has unique experiences and resulting service related needs. In spite of the differences, there is sufficient overlap in the issues.

    • 10. Is Veterans Affairs Canada consulting with women and LGBTQ2+ Veterans when developing policy?

      Yes. Input and discussions with women and LGBTQ2+ Veterans, stakeholder groups, researchers, and other federal departments have been crucial in developing the Office of Women and LGBTQ2 Veterans and its priorities. We want to hear from those most affected – we recognize the need to have a greater understanding the “Nothing about Us Without Us” mantra that women Veterans have been saying to us.

      Veterans Affairs Canada will continue to consult with stakeholders to ensure the unique obstacles, impacts or other concerns the survivors of sexual harassment face in relation to claims and access to Veterans Affairs Canada benefits are considered when developing policy.

    • 11. Why are the challenges women face while in service important when discussing women Veterans and transition of women in the Canadian Armed Forces?

      Serving women are the Veterans of the future, the challenges they face today are important to understand as they may allow us to design programs and services to support them in the future. In addition we may be able to work with Department of National Defence to improve the conditions they face while serving, resulting in greater prevention, earlier interventions and more effective mitigations and supports when needed.

    • 12. Can you recommend resources for Veterans service organizations to help us better connect with LGBTQ2+ Veterans, and ensure that they are aware of our services?

      The Veterans Affairs Canada website includes a section for Women and LGBTQ2 Veterans, and there is a link to the “Building Communities” section containing a variety of links and resources. Under the Office of Women and LGBTQ2 Veterans webpage is a section entitled: “LGBTQ2 Resources” for more specific resource links and awareness of Veteran organizations and stakeholder groups.

  • Section 3 - LGBT Purge

    • 13. As a result of the legal settlement relating to the LGBT Purge, one of the court-ordered mandates was to have the "LGBT Purge Fund" work closely with the Canadian Armed Forces (as well as the federal public service & RCMP) to support the enhancement of diversity & inclusion efforts and to enhance training in this area (for the lifespan of someone's career). How is the Office of Women & LGBTQ2 Veterans participating or supporting this initiative?

      The Office of Women and LGBTQ2 Veterans is intended to identify and address systemic issues and barriers faced by women and LGBTQ2+ Veterans. As such, we have engaged with stakeholders from across this community including those representing Veterans impacted by the Purge.

      We also continue to promote awareness of LGBTQ2+ and Purge survivors through our internal and external communication products and linkages with other training and education tools made available through the Canada School of Public Service or contracted training providers.

    • 14. Does Veterans Affairs Canada have any Veterans who are part of the Canadian Armed Forces Sexual Misconduct and LGBT Purge class action?

      Veterans Affairs Canada has welcomed many Veterans as employees. They offer valuable insight to the experiences of our clientele and represent a range of experiences as former members of the Canadian Armed Forces.

    • 15. What is Veterans Affairs Canada doing to ensure its staff are culturally competent in terms of military service and LGBTQ2+ experiences, particularly the LGBT Purge?

      In order to ensure staff understand the complexity and nuances of the LGBTQ2+ community, Veterans Affairs has launched LGBTQ2+ Cultural Competency training. This 90 minute training takes the form of webinars delivered by experts in the field and will be made readily available to all staff through several offerings over the next year. In addition, staff have been encouraged to understand the Purge by viewing the documentary entitled “The Fruit Machine”, and hearing the public story of Michelle Douglas, a purge survivor. The Public Service also has an active Pride and Positive Space community for LGBTQ2+ individuals and allies, Veterans Affairs employees are also active in these networks.

      Trauma Informed Practice training has been offered to a select group of employees and this training is likely to be expanded in the future. This is intended to sensitize the staff response to victims of trauma.

      Veterans Affairs Canada is offering training courses and resources for staff; including but not limited to:

      • LGBTQ2+ cultural competency training
      • New Workplace Inclusion for Gender and Sexual Diversity
      • History of the Purge
      • The Fruit Machine Documentary
      • Michelle Douglas personal story
      • LGBTQ2+ Secretariat website
      • Sexual Misconduct (class action settlement agreement)
      • Dedicated processing unit to work with class action claimants
      • Gender-based Analysis Plus (GBA+) training – Intersectional impacts on diverse sub-groups, amplifying disparities and the need for more targeted approaches and tailored programs/services to meet unique needs
    • 16. Will the Trauma Informed Practice training and LGBTQ2+ Cultural Competency training awareness training be mandated or available?

      Courses directed by the Canada School of Public Service as mandatory training for various groups of Public Service employees are tracked for participation. Other offerings are encouraged but may not be formally mandated within the department.

    • 17. How will Veterans Affairs Canada ensure that Purge survivors benefit from programs and service in a respectful and dignified manner?

      We know that many Veterans of the LGBT purge continue to suffer unpleasant and unacceptable experiences while seeking help and support for the trauma they have suffered. Some of this is rooted in lack of understanding and knowledge of what the purge victims endured. To address these shortcomings the Department has started to provide cultural sensitivity training such as Workplace for Gender and Sexual Diversity to create more supportive conditions and foster positive interpersonal and institutional relationships with LGBTQI2S colleagues and clients. This training will be extended to our close partners such as the national network of clinics that is funded by Veterans Affairs Canada. We will also leverage the reach of the CoE on Post-Traumatic Stress Disorder (PTSD) to educate the mental health community at large on specific issues pertaining to the LGBTQ2+ community so that no one has to face the type of experience you referred to in your question.

    • 18. How is Veterans Affairs Canada creating a safe space where LGBTQ2+ Veterans feel welcome and acknowledged – in person and in a virtual setting?

      Veterans Affairs Canada created the Office of Women and LGBTQ2 Veterans in July 2019 in response to concerns raised by women and other under-represented groups of Veterans, and to contribute to key federal government commitments to advance gender equality, diversity and inclusion. Part of their mandate is to work with Veteran stakeholder groups to identify systemic barriers and work horizontally through functional areas of the department to address these concerns, incorporating the lived experience of impacted Veterans. There is more work to be done with LGBTQ2+ Veterans and Purge survivors towards achieving safe and welcoming space across all channels of interaction with the department.

      Veterans Affairs Canada is committed to creating a safe space for LQBTQ2+ Veterans. A safe space begins with respect and awareness, there are a number of steps Veterans Affairs Canada is taking to ensure Veterans feel included and recognized.

      Veterans Affairs Canada is offering training courses and resources for staff, including but not limited to:

      • LGBTQ2+ cultural competency training
      • New Workplace Inclusion for Gender and Sexual Diversity
      • History of the Purge
      • The Fruit Machine Documentary
      • Michelle Douglas personal story
      • LGBTQ2+ Secretariat website
      • Sexual Misconduct (class action settlement agreement)
      • Dedicated processing unit to work with class action claimants
      • Gender-based Analysis Plus (GBA+) training – Intersectional impacts on diverse sub-groups, amplifying disparities and the need for more targeted approaches and tailored programs/services to meet unique needs

      A goal for Veterans Affairs Canada is to be more representative of the population we serve, including having more employees who identify as LGBTQ2+.

      In addition to the above, Veterans Affairs Canada is responsible for maintaining a safe space in providing service delivery for Veterans. This includes having options to access services in person and virtually while also eliminating barriers and making interactions open, inclusive, accessible and unintimidating.

      Veterans Affairs Canada is making opportunities for staff, Veterans and stakeholders to grow and learn together through concrete steps such as virtual roundtables and online event series. Veterans Affairs Canada is aiming for real, open and honest conversations to take place and be pursued on a continuous basis.

  • Section 4 - Research Projects and Data

    • 19. How is Veterans Affairs Canada working with other departments to ensure women Veteran research is happening in a whole of government coordinated and collaborative manner to ensure there are no gaps/overlaps?

      Veterans Affairs Canada is working collaboratively with the Department of National Defence and Statistics Canada to increase our capacity to collect data to support quantitative research focused on women Veterans. Statistics Canada is developing a comprehensive registry of Veterans that will draw data from both departments and from historical records at Library and Archives Canada. Data collected through the Veterans identifier question on the 2021 Census will also dramatically enhance the capacity of all federal departments to understand the demographics of the population of women Veterans.

      These two initiatives will provide the Department with more comprehensive data which will allow more robust sex and gender–based analysis. Veterans Affairs Canada is also working collaboratively with Employment and Social Development Canada and Canada Mortgage and Housing Corporation on housing issues and on data on homeless Veterans.

    • 20. What are the latest joint projects or research that Veterans Affairs Canada is participating in?

      Veterans Affairs Canada is working in partnership with researchers at a number of academic institutions. Some examples include the University of Manitoba on the topic of military sexual trauma in Canadian Armed Forces members and Veterans; McGill University on aging Veterans, Dalhousie on chronic pain, the University of Toronto on occupational exposures, the University of Montreal on challenges during release from the military, the University of British Columbia on the financial well-being of Veteran Survivors, and others.

      Many knowledge gaps exist concerning the well-being of Women Veterans, LGBTQ2+ Veterans, and other underrepresented groups, and Veterans Affairs Canada continues to pursue research partnerships in these priority areas.

    • 21. Thinking about the data available on women Veterans, what can we do to help make the data more accessible to facilitate research into action?

      Veterans Affairs Canada is taking steps to more fully represent Women Veterans in research and other forms of reporting. This includes providing more comprehensive sex-disaggregated results and leveraging new data sources that can be anonymously linked to existing surveys through Statistics Canada (e.g. cancer and mortality registries, hospital records, and population-level surveys).

      This increases the feasibility of studying less understood subgroups within military and Veteran populations. The ability to disaggregate by element, sex, or other characteristics of interest will permit the identification of subgroups experiencing higher or lower risk of disease, as well as factors to target through prevention measures.

      Some of this data can also be accessed by non-government researchers through Statistics Canada’s Federal Research Data Centre.

    • 22. It is known that especially for women that qualitative research can be a very important source of identification, understanding and prevention of many conditions. How many qualitative researchers does Veterans Affairs Canada have?

      Veterans Affairs Canada’s Policy team examines both qualitative and quantitative research as part of the policy development process.

      • The Policy and Research teams are within the same Division to ensure synergies, awareness of new and emerging research that impacts Veterans and their families, and that Veterans Affairs Canada has a strong, evidence-based policy suite. For example, Program Policy was involved in a project led by the Research Directorate on a sex-disaggregated profile of Veterans. This published paper includes data on demographics and well-being indicators broken down between men and women, which is a helpful tool when developing policies.
      • Policy also participates in discussions with international partners. For example, in 2019 we participated in a multi-day workshop with colleagues from Australia on their disability benefit program to gain knowledge on their best practices and lessons learned.
    • 23. It is fantastic news that Veterans Affairs Canada will be using Sex and Gender Equity in Research (SAGER) guidelines for all its own research. Will those same standards be enforced by Veterans Affairs Canada for all external research paid for by Veterans Affairs Canada including that done by Operational Stress Injury (OSI) clinics, the Centre of Excellence for Pain and Post-Traumatic Stress Disorder (PTSD)?

      Veterans Affairs Canada is working towards conformity with Sex and Gender Equity in Research principles. The current focus is on implementing the Sex and Gender Equity in Research guidelines in Veterans Affairs Canada’s research, and we are reviewing to what extent and in what ways Veterans Affairs Canada can influence the research conducted by third parties that receive funding through Veterans Affairs Canada.

    • 24. Veterans Affairs Canada has announced their research goals of following Sex and Gender Equity in Research guidelines, sex disaggregation of all data, compensatory efforts in oversampling for women and to consider design from the onset. Does Canadian Armed Forces and Director General Military Personnel Research and Analysis (DGMPRA) research also adhere to these same goals?

      The relevance of sex and gender in the studies conducted by Director General Military Personnel Research and Analysis (DGMPRA) is considered from the start, i.e. when formulating the research question and determining the methodologies for the respective studies. In general, gender and sex data are collected in most social science research projects that are conducted by DGMPRA. Sex is a key stratification and weighting variable in DGMPRA survey research, and is used to ensure accurate sampling; if needed, oversampling based on sex ensures that survey findings accurately represent the female and male Canadian Armed Forces/Department of National Defence populations. Sex and gender are also considered in the design of qualitative studies such as interviews and focus groups, including both single gender and mixed gender focus groups, depending on the topic of the study and the nature of the research question.

      Moreover, the DGMPRA Social Science Research Review Board (SSRRB) adheres to Gender Based Analysis+ (GBA+) informed guidelines when reviewing social science research projects submitted to the Board. While conducting the SSRRB review, the Board applies a GBA+ lens by considering the population under study, the research question, and the methodology. The Sex and Gender Equity in Research guidelines are currently being reviewed by the Board, and the Social Science Research Review Board guidelines will be updated as required to integrate the Sex and Gender Equity in Research guidelines alongside the Government of Canada mandated GBA+ requirements for research.

    • 25. Recognizing the legislative limitations on Veterans Affairs Canada, are there allies with a more comprehensive and fulsome ability to gather data across the gaps and does this data reinforce the snapshot gathered by Veterans Affairs Canada?

      Veterans Affairs Canada works in regular collaboration with allied countries, and we frequently reference research conducted by countries with more integrated military and health care systems, particularly the United States and Australia. These collaborations have served to support and enhance findings from Canadian research.

    • 26. Understanding the "macho" environment of the Canadian Armed Forces, is there any appreciation of perceived under reporting among male Veterans and members as they compare to women? Is there any ability to understand the likelihood of reporting differences between genders?

      The majority of research on Veterans relies on self-reporting of conditions. Veterans Affairs Canada considers self-reported responses from Veterans to be relatively accurate, and we don’t see major discrepancies when there are opportunities for objective comparison, for example with other jurisdictions that are able to clinically validate responses.

    • 27. Are there any plans underway for academic and women-led researchers to study the prevalence, nature, and determinants of female Veteran homelessness?

      Veterans Affairs Canada Research Directorate has partnered with Employment and Social Development Canada to identify Veterans in Canadian homeless counts. The most recent report describes the counts done in 2016, and found that 4% of Canadians experiencing homelessness report Veteran status. Of these, 83% were male, 14% female, and 3% gender-diverse. Veterans were less likely to be female than non-Veterans. Everyone Counts 2018: Highlights - Report.

      These findings are consistent with earlier work that the Veterans Affairs Canada Research Directorate partnered with academics:

    • 28. Are there any plans for Veterans Affairs Canada to work with Canadian Armed Forces Transition Group and the Canadian Forces Health Services Group to collaborate on the female Veteran homelessness research on prevention and intervention?

      Veterans Affairs Canada is not currently engaged in any studies specifically relating to female Veteran homelessness. That said, Veterans Affairs Canada is exploring the potential of the 2021 Census to provide new data about Veteran homelessness, since enumeration will include shelters for persons lacking a fixed address and shelters for abused women and their children.

    • 29. Is there LGBTQ2+ representation when the survey tools such as the 2018 Canadian Armed Forces/Veterans' Mental Health Follow-Up survey; Canadian Armed Forces Transition and Well-Being Survey (2016) and Life After Service Survey (2019) are created?

      The Life After Service Survey does now include questions on gender identity. When new questions are added, they are selected from modules of the Canadian Community Health Survey. This allows comparison with population results, and it ensures that the questions meet the Statistics Canada guidelines. Currently, there are no questions on sexual orientation in broader population surveys. For now, Veterans Affairs Canada will rely on local or targeted tools for this information.

    • 30. Which office should we approach to assist us in creating research questionnaires including all appropriate terms regarding gender as well as trauma?

      The Veterans Affairs Canada Research Directorate can provide assistance. Requests can be sent to vac.research-recherche.acc@canada.ca.

  • Section 5 - Mental Health, Post-Traumatic Stress Disorder (PTSD) and Suicide

    • 31. For suicide in Veterans, do we include Veterans who did not complete basic training? Will there be more information about suicide ideation and attempts again?

      The indicators used in historical reporting of suicides included all Veterans released since 1976 from service in the Regular Force or Reserve Class C. As long as these Veterans were listed in the Department of National Defence pay records, they were counted.

      Suicide mortality rates and characteristics for male and female Veterans are described in the Veteran Suicide Mortality Study (VSMS) reports:

      Suicide ideation rates for male and female Veterans were recently reported: Comparing negative health indicators in male and female veterans with the Canadian general population.

    • 32. Why is it possible to have data on how many Post Traumatic Stress Disorders (PTSD) are linked to Afghanistan but not how many are linked to Military Sexual Trauma (MST) when both are considered sources of PTSD yet Military Sexual Trauma is not tracked?

      As part of the eligibility criteria, disability benefits must be related to service. Therefore, when a client submits an application, we enter the service into our database. For example, we can report on whether the Post-Traumatic Stress Disorder is related to WWII service, Korean War service, Afghanistan service, or RCMP service.

      Thanks to the introduction to a new electronic client system (GCCase) that provides the capability to better capture data, the department is looking at the ability to report on rationales for conditions. The reporting functionality is currently in the development stage and can only be used on a go forward basis as this capability was not available in our previous system.

  • Section 6 - Chronic Pain

    • 33. Are there any unique features/qualities regarding the impact of gender with respect to chronic pain?

      In April 2020, the Chronic Pain Centre of Excellence (CPCOE), funded by Veterans Affairs Canada, commenced their operations. One of the Chronic Pain Centre of Excellence’s priorities is to perform research into sex/gender differences in chronic pain management.

    • 34. What research has been done about gender and/or sex differences in Veterans living with chronic pain?

      Sex differences for Veterans living with chronic pain were recently reported in the following publication: Comparing negative health indicators in male and female veterans with the Canadian general population.

  • Section 7 - Programs and Services

    • 35. What is identity and why is sex, gender (identity, expression, attraction) and sexual orientation important in terms of how programs are designed and delivered?

      Veterans Affairs Canada recognizes that in addition to sex and gender, other identity factors such as ethnicity / race, age, disability, social economic factors, sexual orientation, may affect how individuals experience the department’s programs. Accordingly, Veterans Affairs Canada uses a Gender-based Analysis Plus (GBA+) approach in its program design, policy development, program delivery and reviews to help ensure that these factors are considered and integrated in the design and delivery approach.

      Veterans Affairs Canada does not collect information such as race/ethnicity, family status, or sexual orientation. Veterans Affairs Canada relies on research and stakeholder engagement to help inform our approach and to ensure that the delivery of our programs have the desired outcomes, that any unintended impacts are identified, and mitigation strategies are put in place.

      The manner in which we deliver the program allows the department to apply a Gender-based Analysis Plus (GBA+) lens as the programs are operationalized to ensure that the department is responsive to the needs of the diverse Veteran population.

    • 36. What services, programs and resources meet the needs for women Veterans' physical and mental health well-being?

      Veterans Affairs Canada is consulting with women Veterans, examining and influencing research and doing reviews to identify the needs of women Veterans.

      Specifically, there has been a change in policy as it relates to conditions linked to sexual trauma related to service, which primarily impacts women but also heterosexual men and LGBTQ2+ individuals. The burden of proof has been adjusted to accept the victim/survivor’s statement as evidence and apply the principle of Benefit of the Doubt to the adjudication decision.

      Also in response to the Class Action, a dedicated unit has been set up to handle these claims in a trauma-sensitive manner. In addition, the disability adjudication processes have been reviewed using a Gender-based Analysis Plus (GBA+) approach to identify inequities based on sex and gender ie. lengthier turn-around times for women’s claims. Recommendations are being put forward to address these concerns.

      Finally there is acknowledgement that differences matter and there is a need to better understand the impact of our policies, programs and services on diverse segments of the Veteran population. COVID has clearly shown that marginalized sub-groups are disproportionately impacted by this pandemic and the need to better understand the reasons why, so that targeted programming can be effective.

      Veterans Affairs Canada is committed to ensuring our policy and programs are developed in an inclusive way for all Veterans, including women Veterans.

      At the national level, there is a wide range of programs including Disability Benefits, Financial Benefits, Rehabilitation, and Health Care Programs including Treatment Benefits, Home Care and Long Term Care Services. Many of these programs contain a diverse set of benefits and services and may be delivered using a case management approach to ensure that the program can be tailored to the needs of the individual Veteran.

      The program and policy development approach at Veterans Affairs Canada includes Gender-based Analysis Plus and the use of a well-being model.

      Programs are linked to these domains and we also measure outcomes within each of these domains to help ensure our programs are making a difference. For example, over the last few years a number of programs were introduced which contribute to the outcome of purpose – including Rehabilitation, Career Transition Services and the Education and Training Benefit, to help Veterans achieve well-being within this domain.

      The other fundamental component of program and policy development is Gender-based Analysis Plus (GBA+). This is conducted as a matter of course on policy proposals which will be considered by Cabinet and Treasury Board – this is to help ensure that the programs meet the needs of Veterans and their families. But we’ve also started applying this lens to other areas of our day to day work to ensure that it becomes part of the fabric of Veterans Affairs Canada.

      We work closely with colleagues in other countries in program and policy development, including Gender-based Analysis Plus (GBA+). In the last year or so, we have taken a new approach to measuring outcomes and have started tp analyze outcomes by sex, to see if there are differences, as historically, we reported outcomes at the program level. In the 2019 Life After Service Survey, new questions were added about sex at birth and gender to help us going forward.

    • 37. Why are women paid less of a pension due to their longer life expectancy?

      Neither Veterans Affairs Canada’s Disability Pension nor Pain and Suffering Compensation benefit payments differentiate between sex/gender for payment amounts.

      Only the Additional Monthly Amount uses sex/gender for payment calculations. The Additional Monthly Amount was introduced as part of the Pension for Life in 2019. The Additional Monthly Amount is payable to members and Veterans who were previously paid a Disability Award (DA) but who might have received a higher amount over their lifetime if the monthly Pain and Suffering Compensation (PSC) had been in place at the time they received their Disability Award.

      The Additional Monthly Amount is calculated using the amount of the Disability Award that was paid to a member or Veteran, the monthly amount they could have received as Pain and Suffering Compensation had it existed at the time, and a life annuity calculation, which takes into account individual circumstances such as mortality rates which are based on age and sex.

      To develop this calculation, Veterans Affairs Canada sought direction from the Office of the Chief Actuary. Mortality rates take sex into consideration because life expectancy varies between men and women. The use of the annuity calculation is consistent with standard actuarial practice.

    • 38. What consideration has Veterans Affairs Canada given to continued discrimination and lack of support to LGBTQ2+ Canadian Armed Forces members and Veterans?

      We are consulting with LGBTQ2+ Veterans and examining and influencing research to better understand the service-related needs of these Veterans. The Government of Canada has launched a new policy direction, Gender Inclusive Services, to support a whole of government approach to being inclusive of people of all genders and consider gender diversity in service design and delivery. We are mapping our practices with the intent of modernizing sex and gender information practices. This includes introducing non binary options when gender information is collected or displayed, and collecting or displaying gender information when possible and sex information only when needed.

      A strategic Equality Plan for Veterans is currently being developed by the Office of Women and LGBTQ2 Veterans to improve gender equality, diversity and inclusion for women and LGBTQ2+ Veterans. This Plan will align with the broader Gender-based Analysis Plus (GBA+) Strategy, as well as support the National Gender Equality Action Plan led by Women and Gender Equality (WAGE) Canada. As of August 2020, consultation has been completed with senior officials and a final plan is expected in the fall of 2020.

    • 39. Is Veterans Affairs Canada doing anything to reduce, or better still, eradicate the inconsistencies in quality of service provided by any given case manager?

      Veterans Affairs Canada provides a number of initiatives to support Case Managers in delivering consistent and high quality services to Veterans and their families.

      • New Veterans Affairs Canada Case Managers participate in the National Orientation Training Program, which provides Case Managers with the opportunity to come together as a group to develop and improve their competencies in policies, procedures and the effective delivery of case management services. This training covers fundamentals aspects of case planning, rehabilitation program, financial benefits, and specific topics such as homelessness, screening and communication.
      • Case Managers are provided with regular national direction on policy and procedure updates to ensure consistency in their work practices. In addition, there are opportunities for the sharing of best practices through Case Manager Communities of Practice and training to support all Case Managers on topics such as “Effective Case Planning” and “Rehab Reset”.
      • Quality Assurance is conducted to ensure the requirements of case management are fulfilled and help ensure services are being provided consistently.
      • Case Managers have access to Subject Matter Experts that provide national direction and guidance when support is required.
      • Case Managers are provided a suite of nationally standardized tools to conduct their work. These tools allow Case Managers to ensure Veterans needs are identified and addressed appropriately.

      Veterans Affairs Canada continues to examine ways to enhance services to Veterans. The department completes client satisfaction surveys and conducts Public Opinion Research and utilizes the results to help improve and strengthen services provided to Veterans and their families.

    • 40. What "basic" benefits does Medavie Blue Cross/Veterans Affairs Canada give us for a diagnosis of depression/anxiety/Post-Traumatic Stress Disorder (PTSD)?

      Veterans Affairs Canada’s Treatment Benefits program provides coverage for a variety of benefits and services. The extent of coverage is dependent on a number of factors including how you qualified, your health needs and your individual circumstances.

      To be eligible for Veterans Affairs Canada coverage of health care benefits and services, it must be determined that the service or benefit requested is related to a disability entitled condition. Alternatively, Veterans Affairs Canada coverage for the service or benefit requested may be approved if it is not available as a member or former member of the Canadian Armed Forces nor available as an insured service under the provincial health care system where the you reside.

      The conditions of depression, anxiety and Post-Traumatic Stress Disorder (PTSD) allow for access to health care benefits and services such as:

      • Ambulance Services and Health Related Travel: Ambulance services required for emergency situations or a specified medical condition and coverage for travel expenses incurred to receive health services or benefits.
      • Hospital Services: Treatment services in an acute care, chronic care or rehabilitative care hospital and multi-disciplinary clinics registered with Veterans Affairs Canada.
      • Medical Services: Services of a licensed physician (including medical examinations, treatments, or for reports requested by Veterans Affairs Canada).
      • Nursing Services: Assessments, foot care and nursing visits (medication administration/management, basic wound care, basic/advanced foot care).
      • Oxygen Therapy: Oxygen and accessories as well as respiratory equipment and supplies (oxygen concentrators/compressors, oxygen gas and CPAP/BiPAP machines)
      • Prescription Drugs: Drug products and other pharmaceutical benefits. Standard drugs include many over-the-counter and prescription drugs. Special Authorization drugs include less common, higher cost therapies approved by Veterans Affairs Canada.
      • Related Health Services: Services provided by a Veterans Affairs Canada approved health professional (e.g. physiotherapy, massage therapy, acupuncture, psychological counselling). In many cases, these services must be prescribed by a physician to be approved by Veterans Affairs Canada.
      • Special Equipment: Special equipment (required for the care and treatment for eligible Veterans) when prescribed by a Veterans Affairs Canada approved health professional. Home adaptations/modifications, to accommodate the use of the special equipment in the home, may also be considered.

      For a complete listing of benefits and services which may be covered, as well as their requirements such as pre-authorizations, prescriptions, frequency and/or dollar limits, please visit the Veterans Affairs Canada Benefit Grid located on the Veterans Affairs Canada website: Search VAC treatment benefits.

      It is also recommended to contact Veterans Affairs Canada at 1-866-522-2122 to discuss the specifics of your situation.

    • 41. Will Veterans Affairs Canada be offering Transgender surgery coverage for example: Facial Feminization Surgery?

      The Benefits Review Committee will be researching gender affirmation medical interventions to make recommendation on the types of treatments eligible for funding through the Treatment Benefits program when there is a need linked to a disability entitlement. Facial Feminization Surgery will be considered as part of this review.

    • 42. It is Entitlement Eligibility Guidelines that identify medical conditions, not the Table of Disabilities. The Table of Disabilities determine what rating to be used for an awarded or pensioned condition. What review, if any, is being done on the Eligibility Entitlement Guidelines?

      The Department has prepared a plan to address wait times for disability benefits. The document, “Timely Disability Benefit Decisions: Strategic Direction for Improving Wait Times” focuses on current and planned tactics and initiatives to improve wait times for Veterans applying for disability benefits. As part of the Process Innovation pillar, the need for better decision making tools was identified. This includes modernizing the tools used by decision-makers such as the Table of Disabilities and the Entitlement Eligibility Guidelines. We are currently in the research and analysis stage of this initiative to review and modernize these tools. As with all initiatives, a Gender Based Analysis Plus (GBA+) lens will be applied to this work to ensure all applications are treated and processed equitably. As we progress with our initiatives, we will continue to communicate our updates.

    • 43. The Office of the Veterans Ombudsman report noted that French and women claims have historically taken longer to get decisions on. We know that more francophone adjucators were hired. An internal Gender-based Analysis Plus (GBA+) analysis was mentioned during the vitual event. Can that report be made public?

      The Sex and Gender Based Analysis of disability benefits is an internal document that was designed to assist the Department in determining if there are any inequities in our tools, processes and procedures involved in the adjudication of disability benefits. This document is not intended to be released external to the Department.

    • 44. What training is being given to staff specific to military women's health issues?

      The Centralized Operations Division’s Training and Development Unit welcomes the opportunity to coordinate training for decision makers on health issues affecting military women. This will require experts to lead/present the training.

    • 45. Who internal to Veterans Affairs Canada is the subject matter expert on women's occupational health claims?

      Medical Advisory within the Health Professionals Division is the subject matter expert on women’s occupational health claims.

    • 46. What are the gaps still in research to help determine service relationship for women specific service related claims?

      We will be modernizing the tools used by decision-makers such as the Table of Disabilities and the Entitlement Eligibility Guidelines. We are currently in the research and analysis stage of this initiative to review and modernize these tools. As with all initiatives, a Gender Based Analysis Plus (GBA+) lens will be applied to this work to ensure all applications are treated and processed equitably. As we progress with our initiatives, we will continue to communicate our updates.

    • 47. How are all these important but separate reasons for women's claims being viewed as "more complex" being coordinated horizontally?

      This will be addressed through modernizing the tools used by decision-makers such as the Table of Disabilities and the Entitlement Eligibility Guidelines. We are currently in the research and analysis stage of this initiative to review and modernize these tools. As with all initiatives, a Gender Based Analysis Plus (GBA+) lens will be applied to this work to ensure all applications are treated and processed equitably.

    • 48. Is the Office of Women in charge of being the "quiltmaker" and joining all these "quilt" pieces that together serve as barriers to equitable access/ outcomes/ benefits for women Veterans?

      The Office of Women and LGBTQ2 Veterans is intended to identify and address systemic barriers and issues facing Women and LGBTQ2+ Veterans. As such it plays an advocacy and to some extent a coordination role within Veterans Affairs and with key departments and organizations.

    • 49. What employer training do adjudicators for claims and case managers and health care professionals get from Veterans Affairs Canada to better understand the unique issues and medical injuries/illness for women Veterans?

      The Centralized Operations Division’s Training and Development Unit welcomes the opportunity to coordinate training for decision makers on health issues affecting military women. This will require experts to lead/present the training.

      Veterans Affairs Canada has a number of initiatives to support Case Managers in delivering consistent and high quality services to Veterans and their families.

      • New Veterans Affairs Canada Case Managers participate in the National Orientation Training Program, which provides them the opportunity to develop and improve their competencies in policies, procedures and the effective delivery of case management services. This training covers fundamental aspects of case planning, rehabilitation program, financial benefits, and information on specific topics such as homelessness, screening and communication.
      • Case Managers are provided with regular national direction on policy and procedure updates to ensure consistency in their work practices. In addition, there are opportunities for the sharing of best practices through Case Manager Communities of Practice and training to support all Case Managers on topics such as “Effective Case Planning” and “Rehab Reset”.
      • Quality Assurance is done to ensure consistent services and that the requirements of case management are fulfilled.
      • Case Managers have access to Subject Matter Experts who provide national direction and guidance when support is required.
      • Case Managers are given a suite of nationally standardized tools to conduct their work. These tools allow Case Managers to ensure Veteran needs are identified and addressed appropriately.

      Veterans Affairs Canada continues to examine ways to enhance services to Veterans. The department conducts client satisfaction surveys, Public Opinion Research and uses the results to improve and strengthen services provided to Veterans and their families.

    • 50. What does "military to civilian transition" mean to Veterans Affairs Canada?

      Veterans Affairs Canada is committed to working with the Canadian Armed Forces to ensure that the transition from Canadian Armed Forces service to life after service, is as streamlined and seamless as possible. We have focused our efforts towards three important outcomes including overhauling service delivery, reducing the complexity of the transition processes, and enhancing the well-being of Canadian Armed Forces members, Veterans and their families.

      Transition is not a fixed point in time but rather a process, which occurs before, during, and after military service. Veterans Affairs Canada and Canadian Armed Forces have benefits and services available to serving members, Veterans and their families every step of the way.

      Transition: During your service

      Every Veteran is different and therefore each person experiences transition to life after service in a different way, with different measures of success. The majority of Veterans will transition with little to no difficulty and will only require targeted assistance and support during their transition. However, a significant number Veterans report that they and/or their families experience difficulties adjusting to life after service.

      As part of the transition process, a transition interview is administered to Canadian Armed Forces members up to six months prior to release. During the interview, a screening tool is used to identify risk levels, unmet needs and concerns. This tool was developed using the domains of well-being that are used by both Veterans Affairs Canada and the Canadian Armed Forces and is evidence based. It assists Veterans Affairs Canada staff to align the transitioning member with the appropriate level of support, such as targeted assistance, guided support or case management as well as identify potential benefits and services.

      It is recognized that transition is not necessarily a linear process. Circumstances change and a Veteran who was previously not experiencing any difficulties may begin to struggle and need additional support. The screening tool will be administered again at various points in time during the transition process or whenever the Veteran’s circumstances change. The levels of support will be adjusted to meet any identified risks or unmet needs.

    • 51. What work/programs/initiatives does Veterans Affairs Canada have for knowledge transfer to the civilian health care community to increase their awareness of women Veteran specific medical issues/needs?

      Veterans Affairs Canada funds two Centres of Excellence, one on Post-Traumatic Stress Disorder (PTSD) and related mental health conditions and another on chronic pain. Both of these Centres have a mandate to disseminate knowledge and evidence-based practices in treatment to not only the civilian health care community, but to Canadians. Both Centres have prioritized research and knowledge creation in the area of women Veteran specific issues.

  • Section 8 - Infertility

    • 52. How can service related infertility care issues for women Veterans be added into the awareness of Veterans Affairs Canada?

      The Benefits Review Committee is currently reviewing and will make recommendation on the types of female infertility related treatments eligible for funding through the Treatment Benefits program when there is a need linked to a disability entitlement. This review will assist in implementing a more standardizing approach for the approval of these treatments, thus allowing for more timely decisions.

    • 53. What is Veterans Affairs Canada’s policy for women Veteran service related infertility and other reproductive related illness/injuries?

      If a member or Veteran suffers from a permanent service-related disability – including infertility or other reproductive issues – Veterans Affairs Canada can grant disability benefit entitlement. This disability benefit will usually be Pain and Suffering Compensation paid under the Veterans Well-being Act, but in some circumstances could be the Disability Pension paid under the Pension Act. The member/Veteran is eligible for a disability benefit even if the condition was consequential to another service-related injury/disease rather than directly caused by service or if an existing condition was worsened by service. The amount payable will depend on the extent of the disability. Here are links to some of the disability benefit policies that could apply:

      A Veteran may qualify to receive financial support for treatment benefits or services pursuant to Part I of the Veterans Health Care Regulations, when they are:

      • entitled to a disability benefit ;
      • in receipt of services through the Veterans Independence Program;
      • in receipt of financial assistance through the Long Term Care program; or
      • in receipt of the War Veterans Allowance or would receive it if not also receiving Old Age Security benefits.
      • There are two categories that determine the scope of a Veteran’s eligibility for treatment benefits/services, and associated cost reimbursement:
      • Group A: Receive approved health care benefits which are directly related to a condition for which they hold Veterans Affairs Canada disability entitlement regardless of alternative coverage.
      • Group B: Receive approved health care benefits for any health condition based on a demonstrated health need when the health care benefit is not covered through their provincial health care plan or a third party insurance provider.

      Once an individual qualifies for treatment benefits and services, they are issued a Veterans Affairs Canada health identification card and advised that they can use the card to access approved treatment benefits and services without having to pay for them out of pocket.

      There is no specific policy related to women Veterans and service-related infertility. If an infertility or other reproductive related condition are determined to be related to service and causing a permanent disability, Veterans Affairs Canada will provide coverage for approved healthcare benefits and services related to that entitled condition under pertinent Programs of Choice (POC). In the case of infertility or reproductive related conditions, eligible Veterans may access healthcare benefits and services such as fertility drugs (POC 10 – prescription drugs), ovulation testing kits (POC 7 – medical supplies), room charges for hospital stays (POC 5 – hospital services), and medical specialist assessments and consultations (POC 6 – medical services).

    • 54. What is the Veterans Affairs Canada policy and benefits related to urinary stress incontinence?

      With respect to urinary stress incontinence, if this is diagnosed as a permanent disability and Veterans Affairs Canada determines that it is service-related, then the member/Veteran could receive a disability benefit.

      This disability benefit will usually be Pain and Suffering Compensation paid under the Veterans Well-being Act, but in some circumstances could be the Disability Pension paid under the Pension Act. The member/Veteran is eligible for a disability benefit even if the condition was consequential to another service-related injury/disease rather than directly caused by service or if an existing condition was worsened by service. The amount payable will depend on the extent of the disability. Here are links to some of the disability benefit policies that could apply:

      While there is no specific policy related to urinary stress incontinence, if a urinary stress incontinence condition is determined to be related to service and causing a permanent disability, Veterans Affairs Canada will provide coverage for approved healthcare benefits and services related to that entitled condition under its Programs of Choice (POC). In such cases, eligible Veterans may access healthcare benefits and services including, but not limited to, medications (POC 10 – prescription drugs), medical specialist assessments and consultations (POC 6 - medical services), bladder supplies (POC 7 – medical supplies), and physiotherapist visits for pelvic floor muscle training (POC 12 –related health services).

      A Veteran may qualify to receive financial support for treatment benefits or services pursuant to Part I of the Veterans Health Care Regulations, when they are:

      • entitled to a disability benefit ;
      • in receipt of services through the Veterans Independence Program;
      • in receipt of financial assistance through the Long Term Care program; or
      • in receipt of the War Veterans Allowance or would receive it if not also receiving Old Age Security benefits.
      • There are two categories that determine the scope of a Veteran’s eligibility for treatment benefits/services, and associated cost reimbursement:
      • Group A: Receive approved health care benefits which are directly related to a condition for which they hold Veterans Affairs Canada disability entitlement regardless of alternative coverage.
      • Group B: Receive approved health care benefits for any health condition based on a demonstrated health need when the health care benefit is not covered through their provincial health care plan or a third party insurance provider.

      Once an individual qualifies for treatment benefits and services, they are issued a Veterans Affairs Canada health identification card and advised that they can use the card to access approved treatment benefits and services without having to pay for them out of pocket.

  • Section 9 - Communications and Engagement

    • 55. Will Veterans Affairs Canada be using the result of the study, Experiences of Canadian Armed Forces Members Affected by Sexual Misconduct: Perception of Support study by Stacey Silins, to find ways to better support Military Sexual Trauma (MST) survivors?

      Veterans Affairs Canada is aware of the Canadian Armed Forces study and will assess the findings and implications on Veterans Affairs Canada once it is released.

    • 56. What is Veterans Affairs Canada's policy for conflict of interest for all its employees? Specifically in reference to their involvements with boards, working groups, advisory groups of external agencies that ask for/receive Veterans Affairs Canada funding?

      The Values and Ethics Code for the Public Sector contains the legal and administrative considerations used to determine whether or not any given activity does or does not constitute a conflict of interest.

      In addition, all employees of Veterans Affairs Canada (Veterans Affairs Canada) are subject to the Veterans Affairs Canada Code of Conduct. It is a condition of employment for all persons employed with Veterans Affairs Canada. The Code states that employees are required to report (by submitting a signed Confidential Report form ) to the Director General of Human Resources when: your outside employment or activities might subject you to demands incompatible with your official duties, or cast doubt on your ability to perform your duties in a completely objective manner. The Director General of Human Resources may require that the outside activities be modified or terminated if it is determined that a real, apparent or potential conflict of interest exists.

      A conflict of interest is a situation in which you have private interests that could improperly influence the performance of your official duties and responsibilities or in which you use your office for personal gain.

      For any question on Veterans Affairs Canada Code of conduct, please send an email to: vac.valuesandethics-valeursetethique.acc@canada.ca.

    • 57. Would Veterans Affairs Canada consider developing a "Veteran advocate" program to help identify and support the participatory engagement of lived experience veteran voices in Veterans Affairs Canada's work and ensuring that conflict of interest within the Veteran world is being more transparently identified and addressed?

      Veterans Affairs Canada employees are required to comply with Conflict of Interest Code. With respect to creating a Veteran advocate program to support participatory engagement of lived experience Veteran voices, this is a program that Veterans Affairs Canada is not considering at this time. Veterans Affairs Canada has a large network of stakeholders with which they engage including many Veteran advocate organizations.

      Veterans Affairs Canada is working to substantively engage with Canadians, civil society and stakeholders. In December 2019, the mandate letter for the Minister of Veterans Affairs named public engagement as a priority. The mandate letter notes that it is the responsibility of the Minister to “substantively engage with Canadians, civil society and stakeholders and be proactive in ensuring that a broad array of voices provide advice, in both official languages, from every region of the country.” Further, one of the central roles of Veterans Affairs Canada is to “listen to the suggestions of Veterans, their representatives and stakeholders to guide work and research, and strive to design and deliver programs that meet the modern and changing needs of Veterans and their families.”

      The Veterans Affairs Canada’s Virtual Series: Women Veterans' Forum Update and LGBTQ2+ Veterans Roundtable as well as the six Ministerial Advisory Groups focused on policy, service excellence, commemoration, care and support, mental health and family with members are good examples of participatory engagement. The recent launch of “Let’s Talk Veterans” an online engagement platform is a new tool to ensure that a broad range of voices provide input on issues of importance to Veterans, their families and stakeholders.

    • 58. What is the French word for 'female Veterans' within the Government of Canada?

      Les femmes vétérans is the French for 'female Veterans'.

    • 59. How is Veterans Affairs Canada recognizing female Veterans and LGBTQ2+ clients?

      Women and LGBTQ2+ service members and Veterans have played an important role in our country’s military efforts over the years and continue to contribute to its rich history and heritage. For more information on efforts underway to recognize their contribution – visit

      Your stories, your voice

      Veterans Affairs Canada also has a commemorative web feature that highlights women’s contributions over the years, both in uniform and in supporting our country’s war efforts from the home front. This is an evolving outreach channel and we look forward to expanding our web and social media content on women and members of the LGBTQ2+ community in the future.

    • 60. How does Veterans Affairs Canada recognize modern-era Veterans including those from diverse genders and backgrounds.

      Veterans Affairs Canada honours all Veterans from diverse backgrounds and all ages, who served Canada, past and present, in times of war, military conflict and peace. Stories of men and women in uniform, Veterans, volunteers, and others who have served Canada can be found here: People and stories.

      Veterans Affairs Canada is also currently undertaking consultations on the launch on a new commemorative strategy in 2021 that will see a greater emphasis placed on recognizing the service of modern-era Canadian Armed Forces members. It is planned that each year would have a broad theme focusing on one region of the world that Canadian Armed Forces members have served. An important element of this strategy, however, will be sharing the stories of the individuals who took part in these efforts – individuals who will reflect our country’s diverse population.

    • 61. Why did Veterans Affairs Canada fund Servicewomen’s Salute and Queens University to commemorate service women?

      While a small portion of the budget was allotted for “Project awareness and commemoration events”, the primary focus of the “Servicewomen's Salute Online Portal for Research and Resources” Veteran and Family Well-Being Fund project with Queen’s University is not on Commemoration. Rather, the project is focused on supporting Veteran servicewomen and current servicewomen transitioning out of the Canadian Armed Forces by filling information, understanding, and participation gaps in research and service supports.

      It aims to achieve these goals by creating a centralized research and resource online portal, which is an ongoing robust search catalogue of information resources for Canadian female Veterans’ that addresses their history, experiences, research, as well as current government, business and community supports. The portal will be an online, interactive, and linked directory of aggregated historical and archival information including artifact resources, scholarly research, knowledge translation, networks of subject matter experts and community based supports, personal narratives and artistic expressions by servicewomen sharing their experiences.

      As per the terms of the funding agreement with Queen’s University, they retain ownership of the intellectual property created as part of the project, while Veterans Affairs Canada retains the right to request a license to make use of the information. The intention is that Queen’s University will maintain the online portal after the completion of the project.

  • Section 10 - Diagnosis and Military Sexual Trauma

    • 62. Will Veterans Affairs Canada revise the Operational Stress Injury (OSI) definition to specifically acknowledge that Military Sexual Trauma (MST) is within the mandate?

      The definition will indeed be revisited to include Military Sexual Trauma (MST) within the definition of Operational Stress Injuries (OSIs).

    • 63. What can Veterans Affairs Canada share regarding access to clinics and peer support for Veterans with a Military Sexual Trauma?

      A community of practice, led by Veterans Affairs Canada’s Chief Psychiatrist, is working on better understanding the peer support need of Veterans with a Military Sexual Trauma (MST) and how to best address this need.

      The independent Centre of Excellence on Post-Traumatic Stress Disorder (PTSD) and related mental health conditions is also looking at peer support for Veterans with diverse needs.

    • 64. The United States has a policy that any Veteran that screens positive for Military Sexual Trauma (MST) experiences has free access to Veterans Affairs mental and physical care benefits without needing to do any paperwork or claim. Is there any thought of offering the same barrier free access to Military Sexual Trauma (MST) specific care needs?

      Prior to release, Veterans Affairs Canada and Canadian Armed Forces work together to support the transition of releasing members. This provides an opportunity for Veterans Affairs Canada and Canadian Armed Forces to coordinate services and ensure the appropriate supports are in place as the veteran is released from Canadian Armed Forces. Additionally, if the Veteran has already been released from Canadian Armed Forces, Veterans Affairs Canada strives to render an eligibility decision within the departmental standard 14 days upon receipt of a completed application and services provided as part of the rehabilitation plan. In addition, Veterans can receive some crisis support and counseling under the Veterans Affairs Canada Assistance Program.

      Additionally, Veterans Affairs Canada offers a number of services to support Veterans’ mental and physical health care for which a Veteran does not need to complete paperwork or have an approved claim. Some of the services we currently offer include:

      Case Management: Although Veterans Affairs Canada does not have a program specifically for military sexual trauma experiences, Veterans with complex needs can work with case managers to help ensure that supports can be tailored to their needs. Veterans Affairs Canada Case Managers provide one on one support to Veterans to help identify and address unmet health needs for mental and physical care, including Veterans who disclose that they have experienced Military Sexual Trauma (MST). Case Managers will assist these Veterans in accessing appropriate Veterans Affairs Canada programs and will make referrals to community resources to provide care and support.

      Veterans Affairs Canada Assistance Service: This is a free mental health counselling service available 24/7 for Canada’s Veterans and their families under the auspices of Health Canada’s Employee Assistance Program. This service is administered via a Memorandum of Understanding with Health Canada. Veterans Affairs Canada Assistance Service at 1-800-268-7708.

      LifeSpeak: This is an online mental and physical health information and support resource to Veterans and their families. LifeSpeak is free of charge, and can be accessed online anonymously and confidentially anytime and anywhere. This is a comprehensive health and wellness platform that is web-based and available 24/7. It offers education on a variety of topics, and includes more than 320 videos, podcasts and transcripts, as well as printable tip sheets and action plans all accessible via computers, smartphones and tablets. The educational modules are about 5 to 8 minutes in length and facilitated by subject matter experts in both English and French. There are quarterly campaigns featuring various wellness topics and opportunities to participate in monthly 'Ask the Expert' chat sessions. Topics range from mental health and relationships to financial health and parenting caregiving.

      Operational Stress Injury Social Support(OSISS): This service provides confidential, non-clinical, peer-based, social support that helps individuals return to a healthier quality of life. Its mission is to establish, develop and improve social support programs for Canadian Armed Forces members, Veterans and their families affected by an operational stress injuries. It provides education and training within the Canadian Armed Forces community to create an understanding and acceptance of operational stress injuries. Support is provided by peer support coordinators – available at more than 20 locations across Canada who have the knowledge and resources to help Veterans by putting them in contact with staff at Veterans Affairs Canada and/or the Canadian Armed Forces who can address issues surrounding release, pension, or treatment, with other specially designed Operational Stress Injury (OSI) Programs or community resources. Veterans who disclose that they are survivors of Military Sexual Trauma, they would be to Sexual Misconduct Response Centre who will support members and refer them to a resource in the community.

      OSI Connect: This is a free mental health learning and self-management mobile app developed to help Operational Stress Injury (OSI) patients and their families understand the nature of operational stress injuries and to provide help through the OSI Clinic Network across Canada. The resources on OSI Connect address challenges including post-traumatic stress and triggers, depression, anger, sleep problems, substance abuse, stress management and more.

      PTSD Coach Canada: This is mobile app to help a Veteran learn about and manage symptoms that can occur after trauma. It includes information on Post-Traumatic Stress Disorder (PTSD) and about treatments that are effective; tools for screening and tracking symptoms; easy-to-use tools to help manage stress symptoms; and, information on crisis support and how to get help.

      Mental Health First Aid for the Veteran Community: This is a two-day course tailored to address the most immediate mental health needs of Veterans and the people who care for, and about, them. The goal is to improve our collective capacity to recognize and assist with mental health problems, addictions, and illness by supporting Veterans in the workplace and personal interactions using evidence based practices.

    • 65. Is there a plan to help Veterans who were victims of Military Sexual Trauma (MST) to access services provided by the Operational Stress Injury (OSI) clinic

      Operational Stress Injury (OSI) Clinics address Military Sexual Trauma (MST), if present, in the treatment they provide. As for peer support, a working group is in place to look at how to best address the peer support needs of individuals who have experienced Military Sexual Trauma.

      The independent Centre of Excellence on Post-Traumatic Stress Disorder (PTSD) and related mental health conditions is also looking at peer support for Veterans with diverse needs.

    • 66. Is there a plan to help Veterans who were victims of Military Sexual Trauma (MST) to access services provided by the Operational Stress Injury (OSI) clinic

      To mitigate/avoid such possible biases, Veterans Affairs Canada agrees that more sensitization, awareness building and/or education is needed with the service provider population. This item will be raised by the Directorate of Mental Health with the newly created Centre of Excellence for Post-Traumatic Stress Disorder (PTSD) and related mental health conditions.

  • Section 11 - Education and Career Transition

    • 67. The United States Veterans Affairs (USVA) has a women specific Military to Civilian Transition (MCT) program it offers every military women on transition. Is there any thought by Veterans Affairs Canada to offer the same?

      The goal of the transition process is to deliver standardized, personalized and professional transition services in order to ensure that Veterans and their families haveknowledge of and access to the range of services available to assist them with their transition from military to civilian life and ensure optimal well-being. Early in this process, a transition interview is administered to Canadian Armed Forces members up to six months prior to release. During theinterview, a screening tool is used to identify risk levels, unmet needs and concerns. This evidence based tool was developed using the domains of well-being that are used by both Veterans Affairs Canada and the Canadian Armed Forces. It assists Veterans Affairs Canada staff to align the transitioning member with the appropriate level of support, such as targeted assistance, guided support or case management in accordance with their personal circumstances and needs.

      While a majority of Veterans make a smooth transition from military to civilian life, many women and LGBTQ2+ Veterans are not doing as well as other Veterans due to the unique challenges that they may face. For example, women Veterans are more likely than their male peers to be released from service for medical reasons and they report greater difficulty in adjusting to civilian life, including securing appropriate, stable employment and income. We are continuing to research this area in order to gain a better understanding of women Veterans and their unique needs. As we continue to analyze the outcomes of transitioning members, including women and LGBTQ2+ populations, we will continue to refine our programs and services in order to ensure that their needs are being met.

    • 68. Do we know how many women Veterans are enrolled in post-secondary/higher education and sponsored by the education and training benefit?

      Our Education and Training Benefit was introduced on April 1, 2018 and it’s been a great tool in helping us help Veterans access education and training for their post military life.

      Thus far, we’ve had approximately 4,300 Veterans approved for the Education and Training Benefit, and of these, about 1 in 6 (16%) were female. This is consistent with the proportions of females within our client population.

      As you may know, eligibility for this program is primarily determined by duration of service - Veterans who have at least 6 years of service (2,191 days) are eligible to receive up to $41,738 in funding whereas Veterans with at least 12 years of service (4,382 days) are eligible for up to $83,476 in funding support. These rates are for 2020 and are indexed every year.

      Also just to point out, under the Education and Training Benefit, Veterans can be approved for either “short courses” or “formal courses”.

      Formal courses result in a degree, diploma, certification or designation – this would include, among others, multi-year university programs.

      So far, we have approximately 1,900 Veterans approved for formal courses and of these, about 1 in 5 (19%) are female.

    • 69. What campaigns are currently being run for women Veteran start up businesses? What campaigns are being run to actively recruit women Veterans for government services?

      There are several external services related to Veteran-friendly start-up opportunities and organizations are encouraged to apply a GBA+ lens to their applications process and course content. The ratios of men and women provided with access to training opportunities has been positive. For example, Prince’s Operation Entrepreneur (POE) offers a ‘boot camp’ style workshops for transitioning members and eligible Veterans focused on start-up businesses. Veterans Affairs Canada has provided funding to POE through the Veteran and Family Well-Being Fund (VFWF).

      Veterans have access to priority and mobility for internally and externally advertised public service job opportunities following their service in the Canadian Armed Forces. Women are a designated employment equity group within the public service diversity hiring strategy. There are no current plans to design a campaign to actively recruit women Veterans into the federal public service.

  • Section 12 – Canadian Armed Forces

    • 70. Is there a sense on the percentage of women in the Canadian Armed Forces, and what percentage of these women identify as LGBTQ2+?

      As of early November 2020, 16.1% of the CAF (Regular Force and Primary Reserve) are women. LGBTQ2+ status is not tracked.

    • 71. All of the people in the Kingston Personnel Support Programs class for personnel who needed remedial training for the FORCE test were women. All of them were able to pass all parts of the FORCE test minus the 51 sec shuttles. Does it really matter if someone does that shuttle in 60 seconds? As I think less women would be on chit or have career consequences if the standards are realistic to their actual job?

      The Canadian Forces developed the Minimum Physical Fitness Standard for all military personnel, regardless of trade classification, age or gender. Extensive research provided six Common Military Tasks, which all personnel might be expected to perform in time of emergency included volunteer participants from the Canadian Armed Forces population (N= 656) from April-September 2012. The Gender Free minimum standard is required by law to establish Bona Fide Occupational Requirements (BFOR) in compliance with the Charter of Human Rights. Rushes is the one component of the Fitness for Operational Requirements of Canadian Armed Forces Employment (FORCE) most likely to be failed and responds very well to training. The training focuses on being able to stand up from a prone (lying) position, which is a functional mobility requirement for many roles in the CAF primarily if one has to take cover under fire.

      When developing the FORCE evaluation, the pass/fail rate of the 656 study participants were analysed for adverse impact. Adverse impact was determined if the pass rate of each sub-group was less than 80% of the pass rate of the majority. This approach commonly employed as a legal and established tool for assessing the presence of adverse impact for minority groups. The results of the research demonstrated that any differences between groups for the FORCE test were overcome by offering evidence based training programs ensuring that anthropometry (body size) and gender/age were not limiting factors in achieve a pass of FORCE.

      When comparing male and female performance on FORCE, failure rates are low. Data from the DFIT system for Fiscal year 19/20 indicates a failure rate of 0.2% overall and 0.3% for females (18/6114 evaluations).

      Personal Support Program (PSP) / Canadian Forces Health Services (CFHS), Canadian Forces Leadership and Recruit School (CFLRS) research has demonstrated that those performing in the lowest 10%ile (while still passing) the Rushes are 3 x more likely to suffer from a musculoskeletal injury during training, and while “just pass” is all you need to avoid remedial training, passing with a buffer is better.

    • 72. What is the solution to ensure that women are respected by their brothers in arms and by the army in general?)

      The solution to ensuring women are respected is by prioritizing the respect and value for each and every member of the Defence Team. From recruitment to retention to transition out of service, the DND/CAF treats everyone with the same dignity and respect, recognizing what they contribute to our organization: skills, knowledge, perspectives and every element of a person’s identity that makes them unique.

      Systemically we try to foster an inclusive environment and apply the same standards to men and women so that team members have the same promotion requirements, opportunities, and treatment in the workplace. Having women serve in all occupations, in leadership roles, and sitting at the table ensures that perspective and shows inclusivity.

      We admit that culture change can be slow – but we are committed. Women have been serving Canada in Defence for over 100 years and that contribution has earned respect. All occupation are open to women – combat arms principal amongst them.

      Showcasing the combat arms as a viable option for women by providing accurate, and realistic, depictions of the type of work involved in each occupation is among the strategies undertaken to attract women to those occupations.

    • 73. What is the Canadian Armed Forces doing to make all genders feel more welcomed into the armed forces?

      The Canadian Armed Forces is open and equitable to all. As outlined in various Strong Secure Engaged initiatives, the Canadian Armed Forces has adopted a holistic approach to welcome unique talents, perspectives and cultures of our members through a sustained institutional effort. Our policies, directions and guidance are developed with this at the forefront. Through consultations with our Employment Equity (EE) Advisory Groups (AGs), representing all four Employment Equity groups and our Advisory Groups representing the LGBTQ2+ communities, the Canadian Armed Forces welcomes all genders. Additionally, the Canadian Armed Forces employs a Gender Based Analysis Plus lens to all of our activities, to consider the impact of gender so all our sailors, soldiers, aviators and Special Forces Operators can contribute authentically and equally to our mission.

    • 74. Veterans Affairs Canada commented on the work they are doing to ensure their staff are trauma informed and aware. What is Canadian Armed Forces and specifically the Canadian Forces Health Services (CFHS) doing to ensure the same education level?

      Trauma and violence-informed care and approaches are policies and practices that recognize the connections between violence, trauma, negative health outcomes and behaviours. Trauma-informed approaches minimize the potential for harm and re-traumatization, and strive to enhance safety, control and resilience for everyone seeking health care and related services.

      The Canadian Forces Health Services (CFHS) is committed to supporting trauma-informed practice and sees this not just as a question of reinforcing the training of clinical staff, but to further support the application of trauma and violence informed principles into practice and policy and to ensure it is instilled in our CAF clinics.

      Canadian Forces Health Services is working with Sexual Misconduct Response Centre (SMRC) and investigating trauma informed programs specifically intended for a medical context in several provinces/jurisdictions in order to build on what is already working in the CAF system, and refining existing practices and education.

      Key to our approach will be informing our CFHS staff broadly, not just mental health clinicians who already practice with trauma and violence informed care in mind.

    • 75. Director General Military Personnel Research and Analysis (DGMPRA) identified themselves as the source of "strategic and operational research" for Canadian Armed Forces. What types of research do they not do? Who else in Canadian Armed Forces completes research that may impact on military women?

      Director General Military Personnel Research and Analysis (DGMPRA) conducts personnel research on a range of topics related to military personnel at all points of the military career, from attraction and recruitment all the way through to retention and transition out of the Canadian Armed Forces. Researchers at DGMPRA primarily collect data through interviews, focus groups, and through the administration of questionnaires or validated psychological assessments. Some also conduct workforce analytics using human resources and/or administrative databases.

      Regarding the population of interest, research at DGMPRA focuses on serving Canadian Armed Forces members and their families and, in some cases, the Defence Team as a whole. Because DGMPRA works in collaboration with Veterans Affairs Canada, a few studies have included Canadian Armed Forces Veterans.

      DGMPRA researchers also work in collaboration with other groups within the Department of National Defence/Canadian Armed Forces who are engaged in research, such as the Directorate of Force Health Protection and Directorate of Mental Health. These other groups are engaged in research that may impact on military women, by conducting epidemiological analyses of health records or population health surveys to better understand women’s health and its associated risk or protective factors. Defence Research & Development Canada (DRDC) is another organization conducting research in support of military personnel. Some aspects of the research portfolio delivered at the DRDC Toronto Research Centre may also touch on issues of relevance to military women.

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