Despite progress in Canada in the field of transgender health care, for the more than 100,800 trans or non-binary Canadians, access to gender-affirming care comes with barriers and delays that vary by province.
Fae Johnstone, a trans activist and executive director of Wisdom2Action, a queer-owned consulting group working in transgender health, says that despite an improved national understanding of gender-affirming care, transgender health access seems to have “fallen entirely off the radars of most provincial and territorial governments.”
Johnstone says Yukon and British Columbia are among the best Canadian jurisdictions for access to gender-affirming care, while Ontario and Quebec are somewhere in the middle. Atlantic Canada and the Prairies, meanwhile, "tend to be further behind.” Gender-affirming care, which can include hormone treatments and surgery, is something any family doctor or primary-care provider can offer. However, Ferguson says the majority of Nova Scotia doctors decline to offer gender-affirming care, which she says pushes patients toward the Halifax Sexual Health Centre or prideHealth, part of the Nova Scotia Health Authority.
Charlotte Landry, a 31-year-old IT technician and trans woman from Cole Harbour, is waiting for a surgery date after having waited more than eight months to see one of two endocrinologists in Nova Scotia who write letters for gender-affirming surgery. “There seems to be an assumption somewhere in the medical community that trans people can’t make their decisions or give informed consent without repeated psychological assessment, which is a little unfair,” she said.
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