People of SFU

Improving the health of Two-Spirit people through collaboration

March 14, 2022
Harlan Pruden, a PhD student in SFU’s Faculty of Health Sciences, co-launched (with FHS assistant professor Travis Salway) the Two-Spirit Dry Lab which focuses exclusively on Two-Spirit people, communities and experiences.

Harlan Pruden is done lobbing rocks.

Make no mistake, the long-time advocate is still fighting for the health of Two-Spirit people, but as an agent of change – not as an agitator.

“I’m working for a better tomorrow,” says Pruden, who was twice appointed to Barack Obama’s Presidential Advisory Council on HIV and AIDS.

“I know the work that I’m doing is for the long-haul. I’m sowing seeds and I may never taste the fruits of my labour.

“But I’m comfortable with that. If I plant something and it yields something in 20 years or 40 years or 530 years, that will be OK. That possibility and that hope are what keep me going.”

Improving the health of Two-Spirit people

It’s the possibility of a better tomorrow that led Pruden, a PhD student in SFU’s Faculty of Health Sciences, to co-launch (with FHS assistant professor Travis Salway) the Two-Spirit Dry Lab (2SDL), Turtle Island’s first research lab that focuses exclusively on Two-Spirit people, communities and experiences.

The Lab—called a ‘dry lab’ because they don’t use beakers or Bunsen burners—is a collaboration between 13 Indigenous and non-Indigenous researchers. The team focuses on promoting best and wise practices and health outcomes for Two-Spirit people, those at the intersections of Indigeneity, gender, sexual orientation and geography.

'I discovered that I can still lob a rock, but now I also have to catch it. Now I have to come up with solutions and offer guidance. … It was the coolest thing and the most amazing shift and gift in my activism – I became solutions based. I became an agent for change, rather than just an agitator.'

- Harlan Pruden, FHS PhD candidate

The term Two-Spirit has several meanings within Indigenous cultures, but primarily refers to individuals having both or a blend of masculine and feminine spirits. Pre-contact, or traditionally for many First Peoples, this concept is one of a gender identity, not sexual orientation, and is often separated or distinct from the lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) identities of today’s mainstream understandings and ways.

Salway, who co-founded the 2SDL with Pruden in 2017, says that too often, research about sexual and gender diversity takes a purely ‘Western’ approach.

“It misunderstands the unique function Two-Spirit plays in Indigenous communities,” says Salway, “thereby conflating Two-Spirit with Western identities like gay and lesbian. The 2SDL opens a radically different way of thinking about Indigenous gender and sexuality.”

Pruden’s research tries to understand if, and how, Two-Spirit facilitates health information and wellbeing for Indigenous gender and sexual minority people and communities.

The literature, Pruden explains, shows that there is a positive relationship between one’s connection to culture and one’s health. Therefore, anything that increases cultural pride will increase self-esteem, which leads to better decision-making and better health choices. Likewise, connection and belonging within the queer community also positively affects health outcomes.

“Current theories only speak to one’s race or one’s ethnicity – the Indigeneity part of the culture, or one’s gender and sexual minority,” say Pruden, who, along with Salway, recently received a $492,000, three-year research grant from the Canadian Institute of Health Research.

“There is very little literature and scholarship where those areas meet or intersect like that of Two-Spirit. I’m taking two bodies of knowledge, mashing them together and trying to learn.”

Pruden’s research has three inter-related objectives: to explore research methods that honour Two-Spirit people; to see if being Two-Spirit can lead to better access to health; and to develop new models of Two-Eyed-Seeing research and knowledge translation for Two-Spirit people and communities.


In Cree, Pruden explains, the third-person singular pronoun is gender neutral (and therefore gender inclusive) and simply translates to ‘it’. When it comes pronouns, Pruden is fine with anything (he, she, they, them, ze, zir) so long as it is used mindfully and respectfully.

Pruden’s long journey to SFU

Improving health outcomes for Two-Spirit people is profoundly personal for Pruden, a member of the Nehiyô (Cree Nation) who grew up on the Beaver Lake Cree Nation northeast of Edmonton.

“Growing up on my mother’s reservation, there was an immense amount of structural racism, homophobia and transphobia,” says Pruden. “I internalized that and it became internal homophobia. I was so ashamed of being an Indian and so ashamed of being a little sissy-boy. I started drinking when I was 12.”

Pruden dropped out of school with Grade 8 English and Grade 10 math. At 20, Pruden sobered in a queer AA group in Edmonton in the 1980s, then known as Gay AA.

“I was of the AIDS generation,” Pruden says. “So many of the people who I sobered up with, sobered up to die. I was 20 and was sitting in rooms, listening to stories of, ‘I’m so glad I’m sober – and that I get to die sober.’”

Completing high school at Alberta Vocational College, Pruden attended the University of Alberta, leaving just shy of a degree. Pruden then moved to New York and took an interdisciplinary BA in politics, economics and society at the State University at New York College at Old Westbury.

Graduating at the top of the class and awarded the Presidential Medal of Honor, Pruden joined Hillary Clinton’s senatorial campaign and became immersed in New York State politics. In 2000, Pruden founded the NorthEast Two-Spirit Society, advocating for increased visibility and better health policy and services for Two-Spirit people and communities. The work was noticed by the White House and Pruden was twice appointed as the lone Indigenous member of the U.S. Presidential Advisory Council on HIV and AIDS (PACHA).

“Before the appointment I was just lobbing rocks,” Pruden says. “When I was appointed to PACHA I discovered that I can still lob a rock, but now I also have to catch it. Now I have to come up with solutions and offer guidance to the secretary of health and human services and the White House.

“It was the coolest thing and the most amazing shift and gift in my activism – I became solutions-based. I became an agent for change, rather than just an agitator.”

While on the council, Pruden realized the power of community and allies – having supporters and people who will speak-up on Indigenous matters.

Indigenous people were only mentioned a couple times in the first U.S. National HIV Strategy, Pruden says, but by the strategy’s second iteration, Indigenous people are mentioned five or six times, despite there being only one federally recognized Indigenous person on the council.

That power of collaboration, of community and collective wellbeing is reflected in the daily work of the Two-Spirit Dry Lab.

Turtle Island

The term Turtle Island harkens to some of the first peoples’ creation stories (Anishnaabe, Lenepe, among others) and is used to name the land that we have come to call North America. Turtle Island may be used as well to reference this land mass, while not affirming or recognizing Canada or the United States of America.

The power of relationships, co-operation and collective well-being

For most labs, the research is about the what.

However, for the 13 researchers in the Two-Spirit Dry Lab (2SDL), how the job is done takes priority. There is no hierarchy within the group, and everyone – principal investigators, epidemiologists – gets an equal say.

“When the 2SDL was founded, we got together and held a tobacco ceremony,” says Pruden. “Because we began in ceremony, we are all really attentive to the sacred place that dwells between all of us as 2SDL members. If we arrive at an end point, “the what,” and all 2SDL members are there and there is still kindness and love and respect in our hearts, then wherever we arrive, will be a good and right place.”

2SDL is housed at the B.C. Centre for Disease Control (Pruden is also Indigenous Knowledge Lead at Chee Mamluk, an Indigenous health program at the BCCDC), with support from the Community-Based Research Centre and SFU’s Faculty of Health Sciences. The focus on collaboration and collective wellbeing extends beyond the physical walls of the lab.

“Harlan is a remarkable leader, both for Two-Spirit communities and for the rest of us,” says Salway. “Harlan asks us to rethink the foundation of our approach to public health research, and in so doing, makes our work that much stronger and more effective.”

Meet the team at the Two-Spirit Dry Lab (2SDL), a collaboration between the B.C. Centre for Disease Control, SFU's Faculty of Health Sciences and the Community-Based Research Centre. The 2SDL is called a dry lab because researchers don't use beakers and Bunsen burners.

Researchers meet with communities and identify what the community partner needs to support program or policy work. Based on those community needs, the 2SDL performs its analysis and returns the data and research to the community to support their goals. The 2SDL can then use the data, find a journal and publish. It’s a win for all involved.

“The result is that our community partner gets the information, the data, the research they need to support a program or their policy work,” Pruden says. “It’s a seamless integration. There’s no need for knowledge translation. The medicine has already happened that is Indigenous knowledge translation or simply doing good work in a good way.”