Trans youth challenging barriers to gender-affirming health care

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Image: Used with permission of SAEFTY Ottawa.

Kaeden Seburn is a bachelor of social work student at Carleton University and a community organizer and advocate. Jay Burns is a high school student currently finishing Grade 12. Both are active members of SAEFTY Ottawa, a group run by and for trans and gender-diverse youth. Scott Neigh interviews them about SAEFTY and about the group's use of research and advocacy to challenge barriers that youth face in accessing gender-affirming health care.

Many, though not all, trans and gender-diverse people seek to access various kinds of health-care interventions that affirm their gender. This can include taking hormone blockers and/or hormones, and it can include various kinds of surgical interventions. The history of trans people's struggles to access this sort of care is long, complicated and highly contested. They have won significant victories, but many barriers remain. In Ottawa, most trans or gender-diverse youth who wish to receive gender-affirming care are referred by their family physician to the Children's Hospital of Eastern Ontario (CHEO).

SAEFTY Ottawa -- which stands for Support and Education for Trans Youth -- is Ottawa's only independent youth group for trans and gender-diverse youth. Being independent of formal service-providing organizations allows SAEFTY to remain open to a broader age range than other groups. It allows them to focus on creating spaces that are often purely social, and are about meeting, hanging out with, and making community with other trans and gender-diverse people, rather than the clinical, medical, or pathologizing flavour that can sometimes show up in organization-driven youth groups. And it allows for the possibility of advocacy work, driven by the experiences and needs of trans and gender-diverse youth themselves.

Their recent research into barriers to accessing gender-affirming health care emerged from conversations that just kept coming up in informal ways among the young people hanging out at SAEFTY events. Most SAEFTY members have received care of one sort or another from CHEO, and when they would discuss their experiences, the same kinds of barriers would be mentioned again and again and again.

At a certain point, they decided to do something about it. In consultation with some trans adults who have done similar kinds of work and with a bioethicist, they developed a survey. Through word-of-mouth and online mechanisms, they invited trans and gender-diverse youth who had received care from the gender clinic at CHEO, as well as their parents, to complete the survey and share their experiences.

Their report is based on responses from 53 youth and parents. Many had quite positive experiences in a lot of respects, but many also reported various barriers and negative experiences. This included unnecessary delays to receiving care, inappropriate assessment and gatekeeping processes, medically irrelevant and unnecessarily intrusive questions, pressure to conform to a stereotypical transition path, lack of explanation for various procedures, inappropriate physical exams, and more. Today's participants emphasize that these problems are not specific to CHEO, but are systemic and are much the same as those reported by trans people of all ages across medical institutions throughout North America.

In addition, some youth reported problems even with basic signs of respect like having their correct name and pronouns used -- this seemed to be related at least partially to issues with the records system in the hospital. In general, parents tended to report overall more positive and fewer negative experiences, while the highest proportion of negative experiences were reported by nonbinary youth and transfeminine youth.

Members of the group have met with staff from CHEO both before and after the release of the report, and are encouraged by what they've heard. They are keen to continue to talk and to collaborate with hospital officials and medical personnel, and work towards changes that will reduce barriers to care. They also hope that SAEFTY's work can be part of broader efforts to make change.

Image: Used with permission of SAEFTY Ottawa.

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Talking Radical Radio brings you grassroots voices from across Canada, giving you the chance to hear many different people that are facing many different struggles talk about what they do, why they do it, and how they do it, in the belief that such listening is a crucial step in strengthening all of our efforts to change the world. To learn more about the show check out its website here. You can also follow them on Facebook or Twitter, or contact scottneigh@talkingradical.ca to join our weekly email update list.

Talking Radical Radio is brought to you by Scott Neigh, a writer, media producer, and activist based in Hamilton (formerly Sudbury), Ontario, and the author of two books examining Canadian history through the stories of activists.

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