Pivot is a community health leadership program for Two-Spirit, queer, and trans people with an interest in becoming community health leaders and advocates in their communities. Throughout the Pivot program, participants are given opportunities to establish social connections, advance their health knowledge and literacy, and gain practical intervention skills they need to better identify and collectively respond to the challenges impacting their health and that of their peers.


Two-Spirit, queer, and trans communities have demonstrated extraordinary resilience, repeatedly stepping up and into the gaps to fight for their health, well-being, and rights. It is this resilience that Pivot aims to harness with an assets-based approach to building the capacity of and centring queer, trans, and Two-Spirit communities in developing and delivering community-driven responses.

Stigma and discrimination, including homophobia, transphobia, racism, HIV stigma, and ableism, among others, are primary drivers behind many of the health disparities facing queer, trans, and Two-Spirit people. These drivers perpetuate negative health outcomes amongst 2S/LGBTQIA+ people and create barriers in access to culturally affirming care and support. The Pivot program equips participants with necessary knowledge and skills to dig deeper into issues and to critically assess the root causes of health challenges facing their communities. Pivot's specific focus is identifying how the systems around us contribute to health challenges and what changes need to and/or can be made to those systems to improve 2S/LGBTQIA+ health and well-being.

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Like other community health leadership programs developed and delivered by CBRC and its partners, Pivot aims to:

  • Establish connections – Pivot hopes to enable participants to establish friendships that last beyond the program and connect participants to partner organizations and other community groups that similarly seek to advance 2S/LGBTQIA+ health equity.
  • Improve health literacy – By educating participants on the root causes of health disparities, Pivot hopes to empower them with increased knowledge and capacity to adopt positive health behaviours and access relevant health services.
  • Build skills – Pivot aims to equip participants with key skills for systems change while sharing knowledge and insights that can be applied to a variety of real-world contexts beyond the finished program.
  • Empower participants to be innovative when striving to address health challenges in their communities – Pivot will provide participants with the opportunity to lead the development and delivery of health interventions in order to address issues facing their communities.

Pivot is a multi-pronged program pathway that involves participants progressing through three core modules. Participants are supported through each module by a comprehensive community intervention workbook which is theirs to keep. Following progression through the core modules, participants will collectively design, plan, and implement their own community intervention project.

Note: Pivot’s “core” modules are delivered by local delivery partners as a part of the program. Module materials are provided and are highly adaptable to ensure they are relevant to the local context. In addition to this, there are a number of “open” or “optional” modules that partners can access and deliver alongside the core modules, or partners can develop their own based on their own strengths and local participant interests.

Core Module One

Health Systems: Reweaving the Tapestry of Our Sexual and Reproductive Health

Core Module One, Health Systems: Reweaving the Tapestry of Our Sexual and Reproductive Health is an introductory module in which participants explore key concepts and topics related to health systems change. Participants will learn about what systems and health systems are, the importance of understanding systems to address health systems concerns, power, and taking action towards the health systems change we want to see. This module is intended to empower participants while building their knowledge and preparedness for planning community interventions that improve how 2S/LGBTQIA+ people navigate their sexual and reproductive health and care.

Core Module Two

Interwoven Realities: Critical Issues in Sexual and Reproductive Health in 2023

Core Module Two, Interwoven Realities: Critical Issues in SRH in 2023 situates participants, the program, and participants’ future activities within some of the critical issues impacting 2S/LGBTQIA+ lives. Some of these include the rise of anti-queer legislation in the US and Canada, growing resistance and restrictions to bodily autonomy, and ‘debates’ about trans inclusion in the queer community. This module connects the global to the local, highlighting important movements worldwide and across Canada, with what participants are concerned with and engaged in themselves. With these in mind, participants will explore how these issues are interconnected and will think critically about how to ground their intended actions throughout Pivot.

Core Module Three

Advocacy & Activism: Pulling on the Threads of Fatphobia and Ageism in Sexual and Reproductive Health

In Core Module Three, Advocacy & Activism: Pulling on the Threads of Fatphobia and Ageism in Sexual and Reproductive Health participants delve into two topics in need of systems change – Fatphobia and Ageism in the realm of Sexual and Reproductive Health.

Fatphobia and Ageism are two issues in sexual and reproductive health that impact, or will impact, almost everyone. Despite appearing as distinctly separate issues, both stem from the same underlying source and through the content of this module, participants will be tasked with examining the roots and intersections of fatphobia and ageism to better understand how advocacy, activism, and policy in sexual and reproductive health issues overlap and interrelate. This module invites participants to consider what weight and age advocacy/activism has consisted of, currently is, and can be. Participants do this by examining the relationship/crossover between weight and age biases and, in real-time, map out the pathways and connections from individual acts of advocacy and activism leading to policy and systems change.

This module supports participants in taking the knowledge, strategies, and skills they’ve learned throughout the program and applying them through the development of systems change project concepts (community interventions) that respond to the sexual and reproductive health challenges they have prioritized. These project concepts will provide the foundation for the projects that participants will further develop and then deliver to cap off the program.


Disponible en français.



Pivot culminates in participants applying what they’ve learned through the development and delivery of their own systems change community health intervention. This practical applied component of the program is crucial to ensuring that Pivot doesn’t simply impart knowledge upon participants but gives them a chance to use it and hone their skills through practice so that they can grow into the community health leaders Pivot aims to produce.

The community intervention component of the program is designed to be highly adaptable and will look very different from site to site depending on delivery partner capacity, participant interest, program resources, and the local context.

In the final stage of the Pivot program, participants are tasked with designing and planning a community health intervention related to a sexual health challenge that is happening in their communities. In order to capture and converge both thoughts and new learnings, the Pivot workbook accompanies participants as they progress through the core modules as they build and cultivate the skills needed to be community health leaders.

The work of each Pivot group will be different and highly personal, so we have included some how-to instructions on specific kinds of advocacy tactics, some space to journal and take notes, and guides to help participants design a community intervention proposal.

In redeveloping and refreshing Pivot, we understood that everyone comes to Pivot with a different background. Some of the skills in the workbook may be new learnings, while others may be areas in which you have a lot of experience. Participants are encouraged to use what is helpful, to skip what isn’t, and to feel free in repurposing or re-imagining some of the content to fit their needs and the community interventions they seek to plan.

To learn more about this program, find a delivery partner near you, and for more resources, please visit pivot4change.ca or contact Fowzia Huda at [email protected]

In its first iteration, Pivot was developed as a community intervention program primarily for gay and bi men (cis and trans) and Two-Spirit people. However, with new funding for sexual and reproductive health for the broader 2S/LGBTQIA+ community, we have been able to refresh and expand its focus and its content. CBRC recognizes that delivery partners each have unique needs and serve different audiences, therefore, we leave any decisions concerning expanded audiences to the discretion of local delivery partners – as long as the program continues to centre queer, trans, and Two-Spirit people.

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