Paths (Re)Membered Receives Grant for 2SLGBTQ+ Systems Change with Oregon Tribe

By: Kira Rea


The Paths (Re)Membered Project was selected as a Systems Change grantee through the 2024 Reproductive Health Equity Fund! Distributed by Seeding Justice – an Oregon-based grassroots non-profit that provides long-range and emergency grants to local social justice-driven projects — the 2024 fund aims to strengthen abortion and reproductive care infrastructure throughout Oregon.

The groundwork for the grant recipiency was laid by the Paths (Re)membered and Policy Teams under Resolution #21-03-11 Support for Trans Gender-Affirming Care in IHS, Tribal, and Urban Indian Health Facilities –2021 Strategic Vision and Action Plan. Ratified by NPAIHB delegates in April 2021, the commitment preceded the National Congress of American Indians Resolution AK-21-014 which was adopted during the NCAI Mid-Year Conference in June 2021.

The Paths (Re)Membered Project centers the Two Spirit and LGBTQ+ (2SLGBTQ+) community–its strengths, resiliencies, and histories—in our movement toward health equity. Through community engagement, research, and advocacy, we work toward a liberated 2SLGBTQ+ future, which includes the memories of Two Spirit ancestors, the wisdom of our elders, and the creativity of our young people.

Paths (Re)Membered is recognized for providing a variety of support including training, technical assistance, toolkits, mental health resources, and patient-case recommendations for clinicians meeting the healthcare needs of American Indian and Alaska Native 2SLGTQ+ community members. In 2023, the project received the Institutional Leadership Award at the 2023 LGBT Health Workforce Conference.

Before contact with settlers, many tribal nations across the continent had long histories of respect and inclusion of those in their communities who might today identify as Two Spirit or LGBTQ+. When 2SLGBTQ+ individuals fear discrimination or harassment in healthcare settings, they are more likely to postpone necessary treatment. 2SLGBTQ+ individuals experience health disparities including increased risk of anxiety, depression, HIV, exposure to violence, and suicidality. Access to gender-affirming healthcare is critical and lifesaving for transgender and two-spirit individuals; as outlined in the strategic plan.

In July 2023, NPAIHB passed Resolution #2023-04-08 Support for Delivery of Gender-Affirming Medical Care for Two Spirit, and AI/AN TGD Children, Youth, and Adults. Within this resolution, NPAIHB states “that Tribal Nations have the inherent sovereignty to provide gender-affirming medical care to their patients, including Tribal citizens and Indian Health Service beneficiaries, at their Tribal health clinics or to refer any patient to a healthcare facility in a sanctuary state” and “calls on the President and the Administration…to recognize the inherent sovereign authority of Tribal Nations to provide gender-affirming medical care to their patients.”

NPAIHB and Paths (Re)Membered are committed to creating and maintaining gender-affirming healthcare spaces in IHS, Tribal, and Urban Indian Health facilities. The Systems Change grant, with a sum of $200,000 in provisional funds, will allow Paths (Re)Membered staff to further their work in expanding safe and accessible gender-affirming healthcare and resources to Oregon Tribes.

This funding will allow Paths (Re)Membered to create a resource library (videos and guides) to help clinicians in Indian Health visualize and deliver affirming patient encounters with Indigenous 2SLGBTQ+ patients. Paths (Re) Membered will continue to serve as a National model for Indigenized gender-affirming care.


Paths (Re)Membered is looking to work with an Oregon Tribal Clinic, if you are interested in participating, please contact the Paths (Re)Membered Team via

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