Affirming Professionals
Parents with minors (and many trans people) often start with their family doctor to get a referral to a gender clinic or other clinic which can meet the needs of a trans person. When they meet with these health professionals, they will learn about their options, medical and mental health, and the route that may be taken.
A good place to check out first are organisations and websites such as the Gender Program at the U of A, Trans Wellness Initiative, Skipping Stone and various city Pride Centres. They have a lot of supports to find health providers.
Included for Alberta are:
- various affirmative health-related supports
- sites to help locate trans-friendly doctors, psychologists, family counsellors, endocrinologists and psychiatrists.
- some government and hospital sites
- separate section on articles for doctors about health care for trans and non-binary people.
For the most current community information on accessing health care for trans individuals, you may wish to attend your local Pflag Chapter meeting (currently online). See section titled “Support Groups and Organisations / Alberta & Canada” for chapter meeting contact information. The attendees in the group usually have the most current community information on accessing health care for trans individuals.
Information on mental health supports and information are under section titled “Medical/Mental Health and Crisis Supports.”
See separate pages titled: “Medical / Preservation & Fertility” and “Medical / Hormones & Endocrinology” for information on hormone treatment options, what to expect in regards to body changes, and how hormone changes impact fertility.
For information on surgeries (and surgeons) see “Medical / Surgeries - Information”. For the GrS Montreal hospital that does most of the trans surgeries for Albertans, see section titled “Medical / Surgery @ GrS Montreal (surgery hospital for Albertans)”.
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SOURCE: Sophie Labelle, Assigned Male Comics
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CLINICS OR ORGANISATIONS
– FINDING A HEALTH PROVIDER --
NOTE: The availability of health care in some clinics and organisations has changed since the pandemic, including online appointments.
ALBERTA
* NOTE: The LGBTQ+ Wellness Centre (AKA "The Centre") in Edmonton is now closed. Their phone number is out of service (March 2023).
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A new virtual service -- free for Albertans. Ages 16+.
"Experts in gender-affirming care. Get access to expert gender-affirming care & hormone therapy from the comfort of your home. Gender-affirming care, made for you. We’re committed to improving healthcare equity and access to trans, non-binary, and gender diverse folks.
A complete approach to gender-affirming care. Foria provides all of the services and care you need to support your gender-affirmation journey".
* Connect Virtually: Meet your clinician, an expert in gender-affirming care, to discuss the best treatment options for you.
* Choose a Service: Select the treatment that suits your needs, such as testosterone or estrogen hormone therapy.
* Start or Restart HT: Start hormone therapy – or restart if your treatment has been paused – with your clinician’s support.
* Additional Services: Foria can support you in obtaining surgical referrals & changing your gender markers on identification.
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Funding for Transition Surgeries
Alberta Health Services (AHS). LGBTQ2S+ / Sexual and Gender Diversity.
"MEDICAL TRANSITION: There are several options available for medical transition including hormone therapy and feminizing or masculinizing surgery. Treatment is individualized. Based on your specific health care requirements, your health care provider may prescribe medication (e.g. hormones) or refer you to a Psychiatrist or another expert in transgender care who is registered with the College of Physicians and Surgeons of Alberta. You don’t always need to be assessed by a Psychiatrist (see page for more info).
If you decide that surgery may be needed to relieve your symptoms of gender dysphoria, your health care provider may also refer you to specific specialists to match the surgical approach with your needs.
When considering a surgical option, discuss your needs with your health care provider as they are the best pathway to care."
Topics: Medical transition -- phalloplasty, metoidioplasty, vaginoplasty, breast augmentation & mastectomy.
Includes information on "what is not funded?" Provides link to TOP (Toward Optimized Practice) for primary care providers caring for trans clients. Provides forms for surgery. (ADULT). Click on link on this page for Breast Surgery request form.
Trans Wellness Initiative (Alberta)
“The Trans Wellness Initiative acknowledges that access to affirming health care for trans and gender diverse people is scarce and often difficult to find. As a means to connect community members with culturally-competent and affirming providers, the Trans Wellness Initiative has started an affirming provider directory.
The directory seeks to accomplish the following:
- Enable trans and gender diverse community members to find competent affirming care to suit their health and wellness needs /
- Enable community organizations and healthcare providers to find appropriate services or providers to refer their trans and gender diverse clients to /
- Facilitate awareness and navigation of trans services within the province /
- Facilitate connection among service providers working in trans health and wellness.
The primary focus of the directory is listing health care providers (especially those who are prescribers), but the directory is also intended to eventually expand to include community-based organizations and other trans-affirming services, such as community groups, personal trainers, aestheticians, child care, mutual aid, etc.”
Click here to see current list of health providers.
Trans Wellness Initiative (website)
Numerous health supports for transgender and non-binary Albertans. (see also “Finding a Provider” above)
“The Trans Wellness Initiative brings community members, community-based organizations, and healthcare providers together to improve the health and well-being for trans and non-binary communities. The Trans Wellness Initiative website provides access to: Community education and system navigation resources / Healthcare provider education, and continuing professional development opportunities / Connections between community members and inclusive, knowledgeable providers and services. The Trans Wellness Initiative was coordinated by the Community-Based Research Center, and made possible due to the work and support of multiple partners and stakeholders.”
FTM top surgery in Canada - Alberta
Alberta: https://www.topsurgery.net/canada/#alberta
All provinces: https://www.topsurgery.net/canada/
Worldwide search options, including Canada. May not be up-to-date.
GRS funding in Alberta: Fact Page
By Trans Equality Society of Alberta (TESA)
“In June 2012, the Province of Alberta reinstated funding for Gender Reassignment Surgery (GRS, also sometimes known as SRS, or Sex Reassignment Surgery). This sheet is intended to provide facts to help Albertans seeking to pursue funding for GRS through the Alberta Health Care Insurance Plan.
(Information provided in this fact page is sourced from the Alberta Health Care Insurance Plan Bulletin MED 166A, Summary of Program Criteria for the Final Stage Gender Reassignment Surgery Program, issued August 20, 2012.)”
Medical and other transition options for transgender people
By Healthwise staff of MyHealth Alberta.
Medical care
Trans Wellness Initiative website. Alberta.
“This section offers information about health and medical support for trans folks”..
Covers: feminizing hormones / masculinizing hormones / surgery navigation / PrEP / pelvic health / sexual health
By TESA (Trans Equality Society of Alberta) and Trans Wellness Initiative (twi). With support from the Community-Based Research Centre.
"The Primary Care Resource Guide is a double-sided 4″ x 6″ printable document that trans and gender diverse people can bring with them into the doctor’s office to provide practitioners with links to resources (through either a scannable QR code or URL) on how to offer affirming care and further reading on related best practices."
-- Alberta-based resources
-- Clinical resources
-- eReferral guide and health service code information
-- Examples of informed consent forms
-- Guidelines and standards of care
-- Patient-facing resources
-- Toward optimal practical surgical reference material
-- Provider training opportunities
Talking about being LGBTQ2S+ with your healthcare provider
Alberta Health Services (AHS). MyHealth. 2019.
Suggestions to get the best health care and what to talk about or disclose with your healthcare provider.
"The Alberta Trans Health Network is a collaborative group of healthcare providers, researchers, and community-based organizations interested and actively working in trans, nonbinary, and Two-Spirit health in Alberta. This network was created jointly by several organizations including the Community Based Research Centre, Edmonton Men’s Health Centre, and Pride Centre of Edmonton after community consultations identified a lack of connection between the many excellent trans health initiatives in the province.
The Alberta Trans Health Network meets online every month to share resources and research, provide updates on initiatives, make connections with others involved in similar work, and discuss current events in the world of trans health.
The goals of the Network include:
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facilitating connection
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increasing capacity
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supporting awareness of initiatives
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fostering collaboration
The Alberta Trans Health Network is open to anyone working in trans health in Alberta, or who has an interest in doing so. Please consider joining!"
Click for EMAIL.
Transgender health care (Alberta)
Alberta Health Services
TOP (Toward Optimized Practice) Resources
“Educational resources for primary care physicians for working with transgender clients”
Transgender health in primary care: Initial assessment
Alberta Health Services. TOP (Toward Optimized Practice). April 2019. Booklet.
“These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making. This practice tool is designed to be used by primary care providers who encounter an adult patient who is seeking care for gender dysphoria. It is intended as a starting point for physicians who see themselves as not expert in this area. This tool can be similarly helpful for any physician such as psychiatrists, internists, gynecologists, surgeons, and others who may find themselves seeing transgender patients for various reasons in a range of clinical contexts. The content is based on international standards of care and was adapted, with permission, from Canadian sources.”
CALGARY
Foothills Medical Centre, Calgary, Alberta. Also known as Transgender Clinic.
Location: South Tower, 1403 29 Street NW, Calgary, Alberta T2N 2T9
Phone: 403-944-5872 / Mon-Fri 8am-4pm
"Provides assessment and support for individuals throughout their transition by facilitating connection to hormone providers and / or gender-affirming surgeries.
This clinic provides:
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comprehensive assessment regarding gender identity
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treatment of co-occurring mental health concerns (e.g. mood and anxiety related to gender)
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education and support regarding social transition (e.g. family, work, legal document changes)
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referrals to access hormones and / or surgery required for transition
Service providers may include: doctors, psychiatrists, psychologists, therapists
Eligibility: Persons 18 years of age and older who are questioning their gender identity or who are wanting to socially / medically transition.
Service Access: Healthcare providers should consult the Alberta Referral Directory for service referral information.
For urgent matters, please call the clinic.
Wait Times: Typical wait times for this service are variable and range from 12 - 24 months but typically closer to 24 months"
The Alex Community Health Centre
The Alex Community Health Centre serves Calgary, Red Deer and southern Alberta.
“Our vision is to facilitate streamlined access to trans and gender diverse healthcare in Alberta.
The Alex in Calgary retains multidisciplinary teams of clinicians and allied professionals including psychiatry, family medicine, endocrinology, uro-gynaecology, gynaecology, psychology (both individual and group offerings), nursing, social work, and peer support.
We are also connected to additional professionals (with an emphasis on primary care) in the community who provide care to the trans population. Using this network, we aim to provide compassionate and easily accessible care while working to de-pathologize gender diversity.”
Gender Identity
By Family & Community Resource Centre. Calgary.
Supported by Alberta Health Services (AHS) - Resources and Support to Families; and Alberta Children's Hospital.
"Most people's gender identity matches their anatomy. However, for some people this is not the case. Below are some resources that can be helpful in understanding those experiences as well as how to support those around you."
Links to ACCESS Mental Health / Trans Lifeline / Kids Help Phone / Calgary Distress Centre. Book suggestions and other helpful resources.
EDMONTON
University of Alberta Hospital, Edmonton, Alberta.
“The Gender Program helps persons across the age spectrum who feel that their assigned sex at birth is misaligned with their lived gender. The service is an innovative program which offers a multidisciplinary approach to the diagnosis and management of gender dysphoria. It provides comprehensive assessments and facilitates gender-affirming interventions to help individuals lead full comfortable lives.
This service offers: Psychiatry, endocrinology, pediatric and adolescent medicine, and nursing support / Referrals to surgery and other specialties / Information about supports available in the community”
*Referrals to the program can be sent by a doctor, nurse practitioner, psychologist or social worker. Get in touch for information about the wait list and services provided.
Contact by email: genderprogram@ahs.ca or phone: 780 - 407 - 6693
ARTICLE: New clinic for transgender Albertans first of its kind in prairies, psychiatrist says . Edmonton Journal, January 25, 2018.
Pride Centre of Edmonton.
"Please ask our information & referral specialists for lists of local friendly and affirming service providers, including family doctors and general practitioners. Our information & referral specialists can also help you navigate gender transition, including health care and non-medical resources."
Health & care
Pride Centre of Edmonton
Offers “information and referral services.” Health resources are listed.
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AFFIRMING DOCTORS & HEALTH
PROFESSIONALS WORKING WITH
THE TRANS COMMUNITY IN ALBERTA
Numerous organisations may be able to provide names of affirming doctors, including;
-
Trans Wellness Initiative
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Gender Program at the University of Alberta in Edmonton
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Skipping Stone
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The Alex in Calgary
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IN MEMORIAM
Dr Michael Marshall 1978-2022
"Dr. Michael Marshall's death an 'irreplaceable' loss for transgender health services in Alberta"
By Madeline Smith for the Edmonton Journal, Oct 13, 2022.
Dr Marshall, a highly respected psychiatrist who ran the U of A Gender Program and opened the LGBTQ+ Wellness Centre in Edmonton, passed away in September 2022.
He was a tremendous advocate for transgender health and wellness in Alberta as well as with CPATH and WPATH.
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ALBERTA
Dr Catherine Flood
Lois Hole Hospital for Women
Clinic C/D Robbins Pavilion
Royal Alexandra Hospital
10240 Kingsway Avenue NW
Edmonton, AB T5H 3V9
EMAIL: lhh.womensurogyne@ahs.ca
PHONE: 780 735 5290
FAX: 780 735 589
They have a multidisciplinary pelvic floor team at the Lois Hole Hospital for Women and provide care for a wide range of pelvic health concerns...and other pelvic health issues.
Dr Flood and her team also provide post-surgery care for trans clients.
Referral is required to access the clinic. Their catchment area includes Edmonton zone, northern Alberta, Northwest Territories, Northern British Columbia, Western Saskatchewan.
WEBSITE: https://www.edmontonurogynecology.com/
HOW TO ACCESS SERVICES: https://www.edmontonurogynecology.com/contact
DR FLOOD'S ONGOING RESEARCH WORK IN GENDER DIVERSE CARE
Research In Gender Diverse Care
Access to gender affirmation surgery in Alberta is limited, with the majority of patients undergoing 'bottom' surgery having to travel all the way to Montreal. Recognizing the need for post-operative care for patients returning from Montreal, we initiated a gender clinic within the Urogynecology Wellness Centre to assist patients in achieving the best possible results from their surgery.
We are currently conducting several research projects surrounding the care of gender diverse patients that access our services.
--- STUDY ONE:
Objectives: To outline the clinical environment in Edmonton for transgender patients to receive perioperative care, as well as to describe the clinical needs and complications for which patients seek care and the outcomes of treatment in the clinic.
BACKGROUND: In Canada, the majority of gender-affirming surgery is performed at the Centre Métropolitain de Chirurgie in Montreal. Transgender patients often travel far distances to receive gender affirming care, and only remain there for a brief period of time post-operatively. When they return home, they may not always have access to a physician who is able to address their post-operative needs or complications.
To enhance the care provided to transgender patients in Edmonton, Dr. Cathy Flood has initiated a multidisciplinary peri-operative clinic (The Gender Clinic) to improve patient outcomes, decrease the burden on the emergency department, and to reduce the number of patients requiring transfer back to Montreal for post-operative care. We hope that this paper will help to provide a framework for other centres to develop a similar peri-operative model of care in locations where gender affirming surgery is not yet available.
METHODS: The research team will be describing the Gender Clinic and the care path for patients referred to the clinic. A retrospective review of 138 patients seen in the clinic has been performed to describe the patient population demographics, as well as to assess for post- operative complications.
RESULTS AND CONCLUSIONS: In progress
--- STUDY TWO:
Accessing Gender Affirming bottom surgeries in Alberta: a qualitative study
By A. Howard , C. Flood MD and J Schulz MD
"Although existing research indicates that financial costs and access to culturally-sensitive physicians represent significant challenges for transgender patients seeking gender-affirming surgical care (El-Hadi et al., 2018), there is no literature on how long-distance travel amplifies financial or access barriers or how it impacts the surgical experiences and outcomes of Albertan transgender people.
To address this gap, this project surveyed the transgender patient population of the gynecology/urogynecology clinic at Edmonton’s LGBTQ+ Wellness Centre. A qualitative survey assesses how long-distance travel for pre-operative assessment, surgery, and post-operative care intersects with financial, social, and access barriers. Patients have been interviewed and the qualitative data is being assembled for publication, with the long-term goal of contributing to the development of a local surgical program for transgender care in Alberta."
Article about Study Two:
Exploring barriers faced by transgender Albertans
Women & Children's Research Institute, Univ of Alberta. Edmonton. Sept 2021.
"A University of Alberta research project investigating the barriers transgender Albertans face when seeking gender-affirming surgery will hopefully contribute to the development of an Albertan surgical program for transgender care.
Alexander Howard, a second-year medical student, explained Alberta lacks a local surgical centre that performs gender-affirming bottom surgeries — such as vaginoplasty, phalloplasty, and metoidioplasty — and transgender patients must travel out of province to a clinic in Montréal for these procedures. Although these surgeries are publicly funded, patients are responsible for covering the cost of medical supplies and for any companions who travel with them to help with their recovery."
_________________________
Simone Lebeuf, MD FRCPC
Adolescent Medicine Pediatrician
The Gender Program, University of Alberta
@ Stollery 1D1 Clinic: 780-407-6370
@ Gender Program: 780-407-6693
She/Her
Dr Lebeuf has been educating doctors who may be working with trans clients. She is also one of the pediatricians working with trans and gender diverse patients at the University of Alberta Gender Program.
Dr Anna Rogers
Endocrinologist
201 - 11044 82 Ave NW
Edmonton, AB T6G 0T2
Tel: 780-250-4880 // Fax: 780-250-4881
Family physician who works with Indigenous and trans clients.
“Transgender Care: Dr Makokis is internationally recognized for his work in providing transgender care in Alberta. View these documentaries highlighting his visionary work.”
A Cree doctor's caring approach for transgender patients
Walking in two worlds: Canada's 'two-spirit' doctor guiding trans teenagers
Whole Medicines A traditional approach to caring for Indigenous and trans patients
Keynote: Two-Spirit Rites of Passage
https://www.drjamesmakokis.com/leadership
Myth-busting gender affirming care with Dr Jillian Demontigny!
The Breakdown. Podcast. Episode 6.I5 on Mar 6, 2024.
"A myth busting special with an actual physician who actually provides gender affirming care! We cut through all the noise on puberty blockers, hormone replacement therapy, surgery and a whole lot more with Dr. Jillian Demontigny!"
Dr Demontigny is a family physician in Lethbridge.
Calgary sexual health doctor reacts to Alberta gender identity policy
"Calgary physician, Dr Ted Jablonski, joins Global News Morning Calgary to discuss the province's new gender identity policy announced by Premier Danielle Smith, and outlines his concerns around what it could mean for the trans community."
Dylan Moulton B. Sci. PharmD
Pharmacist / Pharmacy Manager
9117 82 Ave, Edmonton T6C 0Z4
Ph 780 440 4365 / Fax 780 440 6712
Email: millcreek@medi-drugs.ca
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Queer & Trans Health Collective (QTHC)
Suite 202, 10526 Jasper Ave, Edmonton
"The Queer & Trans Health Collective (QTHC) is a grassroots health organization run by and for queer and trans community members.
Our vision is for all queer and trans community members to have equitable opportunity to experience positive health and well-being.
Working alongside our community, we empower queer and trans well-being through programming which promotes equitable access to health education, support, capacity building, community-based research, and provider training."
QTHC Training For Health Professionals
"Queering the Compass: Pathways to 2S/LGBTQIA+ Sexual and Reproductive Health is a free training program for health care workers, service providers, and students.
The program promotes sexual and reproductive health within 2S/LGBTQIA+ communities while improving the capacity of health care workers and service providers who serve them.
This training will address gaps in health care services and empower health care professionals in providing inclusive care. This training is set for on Saturday, March 23, 2024, 9:00AM-3:00PM and can be attended either in-person or virtually. The in-person event will be held at a hotel in downtown Edmonton and will be streamed live virtually through Zoom. Breakfast, lunch, and refreshments will be provided for in-person attendees. Certificates of completion will be provided upon request.
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OTHER CANADIAN PROVINCES
BRITISH COLUMBIA
BC residents have their own hospital for some affirming surgeries. These resources are for general interest.
BC brings gender-affirming surgery for trans people closer to home
Ministry of Health News Release. Nov 16, 2018.
Excerpt: “Reconstructive gender-affirming surgeries will be available within Vancouver Coastal Health starting in 2019. In addition, trans people throughout the province now have improved access to publicly funded gender-affirming chest and breast surgeries. A total of 14 surgeons will provide these surgeries in Burnaby, Kamloops, Kelowna, Port Moody, Prince George, Vancouver and Victoria.“
Access to trans surgical health care in BC
By Gail Knudson MD, MPE, FRCPC; Clinical Associate Professer at UBC; Medical Lead, Transgender Health Information Program, Vancouver Coastal Health. Vancouver, BC.
"Outline:
∗ World Professional Association of Transgender Health
∗ Canadian Medical Association
∗ Canadian Professional Association for Transgender Health (CPATH)
∗ Health Care Delivery in British Columbia
∗ Access to Trans Surgical Health Care in BC
∗ Resources "
BC Children’s Hospital (BCCH) Family Support & Resource Centre
The Resource Centre has collected a number of books and other media on topics of interest to gender-questioning and transgender children and youth, and their families.
By Trans Care BC.
“A supportive environment is important for gender creative, trans or questioning children and youth.” Directs to many resources.
By Trans Care BC.
"Information to help you support your child in exploring and expressing their authentic gender selves, so they can meet their fullest potential in life.
Parenting a gender creative child or trans youth can have its challenges. It can also be a rewarding experience filled with love and learning.
As parents and caregivers, you want the very best for your child. You also deserve access to the information and support you need as you navigate your family’s unique journey. The pages in this section have information that you may find helpful as you start your journey."
Gender identity and transgender issues
By HealthLink BC
BC-specific info, but general info applies to Albertans.
BC Children’s Hospital (BCCH) Family Support & Resource Centre
Gender Resources: the Resource Centre has collected a number of books and other media on topics of interest to gender-questioning and transgender children and youth, and their families.
Trans Care BC
"Finding care providers who understand trans health issues is important. This kind of provider might be a primary care provider, a counsellor or another health care professional.
Our health navigation team helps connect people in BC to gender-affirming health and wellness supports. Based out of Vancouver, the team includes health navigators, nurses, peers, and admin support staff, with access to a general practitioner for consultation as needed. The team works alongside service providers and community contacts from across the province to help people find care and support as close to home as possible."
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For information on our services, see Who We Are.
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If you need help accessing gender-affirming care in BC, please Contact Us and we will try to help connect you with resources as close to home as possible.
Improving gender-affirming care across BC
Trans Care BC Provincial Health Services Authority.
"Trans Care BC supports the delivery of equitable and accessible care, surgical planning, and peer and community support for trans people across the province."
http://www.phsa.ca/transcarebc/about/who-we-are
“Trans Care BC supports the delivery of equitable and accessible care, surgical planning, and peer and community support for trans people across the province”
Excellent general information for Albertans. Trans surgeries in BC are not available to Albertans.
NORTHWEST TERRITORIES
N.W.T. drops psychiatrist's diagnosis as requirement to receive 'gender-affirming' care
New guidelines aim at tackling discrimination against transgender patients in health system
By John Last. CBC News. Last Updated Jan 29, 2021.
"N.W.T. health authorities have eliminated a requirement for transgender people to receive a psychiatric diagnosis before they can be referred for 'gender-affirming' care."
ONTARIO
Ontario residents have a hospital in their province for transgender and other affirming surgeries. These resources have a lot of general information of interest. Services are only available in Ontario.
Ontario-based.
A model for telehealth for trans clients. Available for Ontarians.
"Connect-Clinic offers specialty services to trans and gender diverse individuals, including non-binary and genderqueer folx. The term trans refers to transgender, transsexual, gender non-conforming, and gender questioning persons. Different medical treatment plans and supports are offered in order to meet individual needs and goals.
This program offers telemedicine-based medical consultations, advice and treatment related to trans care, including general health and wellness services, hormone therapy, and surgery referrals. All services are covered by Ontario Health Insurance Plan (OHIP). Referrals to this program are appreciated and accepted, though they are not necessary."
CHEO (Children's Hospital of Eastern Ontario).
Our clinic accepts referrals for children and youth living in Ontario only.
"CHEO’s Gender Diversity clinic supports children, youth and families at all stages of their journey with gender identity. During your visit you will meet clerks, nurses, social workers and physicians from the Adolescent Health and Endocrinology teams. You might also meet staff from other areas across CHEO."
Guidelines for gender-affirming primary care with trans and non-binary patients: A quick reference guide for primary care providers (PCPs)
“This quick reference guide was derived from Sherbourne’s Guidelines for Gender-Affirming Primary Care with Trans and Non-Binary Patients and is designed to be used in conjunction with the full Guidelines.”
North Simcoe Muskoka Trans Health Services
Health & Wellness Website
“Trans-affirming supportive approach for Trans people seeking health care in our region.”
Rainbow Health Ontario
"Rainbow Health Ontario creates opportunities for the healthcare system to better serve LGBT2SQ communities."
(Sherbourne’s) Guidelines for gender-affirming primary care with trans and non-binary patients: 4th edition
Authored by Dr. Amy Bourns, a family physician on Sherbourne’s LGBT2SQ Health Team. 2019.
“In addition to incorporating recently available evidence in both general primary care and trans health, the 2019 edition features revisions and expansions in several areas, including: expanded discussion of considerations for non-binary patients; unique considerations for older trans patients; subtle language changes that reflect the rapid pace of cultural change; an expanded discussion of fertility considerations for trans people; discussion of alternate routes of hormone administration; an overview of the role of PCPs in supporting patients with transition-related surgeries; and The Trans Primary Care Guide, the online interactive tool based on the Guidelines, has also been updated… You may also want to access the Quick Reference Guide that was created to accompany the full Guidelines.”
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CANADA-WIDE
3 Types of trans healthcare that everybody should know about
By Meaghan Ray. Purple and Green and the Life In Between blog post. Nov 2021.
"When we hear about trans people and healthcare, we mostly hear about hormones and surgery. But trans people are way more than just hormones and surgery. As part of my current research, I am learning about the different types of barriers that trans people experience when accessing healthcare."
The Canadian Professional Association for Transgender Health (CPATH)
“…is a national, multidisciplinary professional organization working to support the health, wellbeing, and dignity of trans and gender diverse people.”
https://cpath.ca/en/ English
https://cpath.ca/fr/ French
Being safe, being me 2019: Results of the Canadian trans and non-binary youth health survey
SARAVYC (Stigma and Resilience Among Vulnerable Youth Centre), UBC. Vancouver. 2019.
“Developed in consultation with trans and/or non-binary advisory groups across Canada, recommendations to improve the health and well-being of trans and/or non-binary youth included inclusive and comprehensive sex education, safer washrooms and public spaces, and decreasing health disparities between provinces.”
SARAVYC is an international, multi-disciplinary, award-winning team that studies how resilience, stigma, discrimination, violence, and trauma affect young people’s health.
Canadian Paediatric Society. "Caring for Kids: Information for parents from Canada's paediatricians", Last updated Mar 2021.
Additional resources are included at end of article.
“Gender identity refers to the deep and intimate feeling a person has of themselves. Children begin to understand and express their gender identity early in life. This article discusses how gender identity typically develops and how parents and caregivers can promote healthy development of gender identity and expression in children. It's important to remember that each child is unique and may develop at a different pace.“
TransHealthCare database.
Publicly funded gender affirming medical care in Canada
By Canadian Professional Association for Transgender Health. UFCW Canada. 2018 (map)
Outlines (by province) all the locations where particular gender-affirming surgeries take place. Listed by name of surgery.
Study shows transgender youth have high parental support, but lack access to care
CBC News. Posted Oct 15, 2021.
Study published in October(2021) issue of journal Pediatrics.
"A first-of-its-kind study gives a glimpse into the experiences of 174 transgender youth across Canada over a two-year period, highlighting the importance of parental support and the lack of timely access to care, which had a significant effect on their mental health."
TransPulse Canada Study (list of research reports)
“Trans PULSE Canada is a community-based survey of the health and well-being of trans, non-binary and two spirit people in Canada. The national survey collected data over the course of ten weeks in the summer of 2019. The project collected survey data from 2,873 trans and non-binary people.
- Health and well-being among non-binary people. Posted Jul 6, 2021.
- Health and well-being among trans and non-binary youth: Health disparities and the importance of social support. Jun 25, 2021.
- Health and health care access for trans and non-binary people in Canada
- Health and well-being among Indigenous trans, two-spirit and non-binary people
- MTHF 2021 – Exploring the health experiences of Indigenous trans, two-spirit and gender diverse communities: A scoping review
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US & INTERNATIONAL RESOURCES
Supporting and caring for transgender children
By American Academy of Pediatrics, American College of Osteopathic Pediatricians and Human Rights Campaign (HRC). Sept 2016.
“... is a groundbreaking resource that explains how families and healthcare professionals are helping transgender children thrive."
WPATH (World Professional Association for Transgender Health)
“The World Professional Association for Transgender Health (WPATH), formerly known as the (Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a 501(c)(3) non-profit, interdisciplinary professional and educational organization devoted to transgender health. Our professional, supporting, and student members engage in clinical and academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender, and gender-nonconforming individuals internationally. We are funded primarily through the support of our membership, and through donations and grants sponsored by non-commercial sources.“
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INFOGRAPHIC CREDIT:
Areas to consider when assessing a paediatric transgender or gender diverse patient. WPATH, World Professional Association for Transgender Health.
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ARTICLES / BLOG POSTS / BOOKS / VIDEOS
CANADIAN RESOURCES
Transgender health: Tips for inclusive care
Developed by Linden, Jenn Bhatla, Dr. Simone Lebeuf, and Dr. Jorge Pinzon for
PedsCases.com. March 26, 2018 (Alberta)
“The objectives of this podcast are to:
1. Develop an approach on how to talk to children, teens and parents about
gender
2. List ideas of how to make healthcare settings more inclusive
3. Identify quality resources for health professionals, patients and families to
access to advance their knowledge on the subject of gender identity”
[PedsCases Podcast Scripts. This is a text version of a podcast from Pedscases.com on “Transgender Health: Tips for Inclusive Care.” These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes or at www.pedcases.com/podcasts.]
3 Types of trans healthcare that everybody should know about
By Meaghan Ray. Purple and Green and the Life In Between blog post. Nov 2021.
"When we hear about trans people and healthcare, we mostly hear about hormones and surgery. But trans people are way more than just hormones and surgery. As part of my current research, I am learning about the different types of barriers that trans people experience when accessing healthcare."
Centre Metropolitain de Chirurgie – CMC
GrS Montreal blog TransAvenue, November 2019
“The Centre Metropolitain de Chirurgie is the only private hospital center in Quebec and is part of the Complexe chirurgical CMC. It has been accredited by Accreditation Canada with Exemplary Standing. This is the highest accreditation status in Canada. The Centre Métropolitain de Chirurgie also performs more than 1000 gender affirmation surgeries every year. The latter are managed in conjunction with GRS Montreal, another subsidiary of the Complexe chirurgical CMC. In all cases, patients are tended to by our medical staff for their preoperative and postoperative care..”
Amazing Canadian website for kids, parents, allies. LOTS of resources.
Gender identity and transgender issues
By HealthLink BC
Includes BC specific info, but general info applies to Albertans.
Gender transition
By Pride Centre of Edmonton. Resource list.
“Please ask our “information & referral specialists” for lists of local friendly and affirming service providers, including family doctors and general practitioners. Our “information & referral specialists” can also help you navigation gender transition, including health care and non-medical resources. Learn more about the ways we offer support for trans, non-binary, and gender-diverse people in Edmonton.”
How to be a trans inclusive health care professional
By Meaghan Ray. Purple and Green and the Life In Between blog post. Aug 2021. (Alberta)
“Trans people experience a wide range of barriers to health care including overt discrimination, uninformed health care professionals, systemic discrimination, and personal biases. As a result, trans people frequently have negative experiences in health care settings and often avoid accessing health care services even when it is necessary. Ultimately, this leads to significant health disparity. This is compounded by having intersectional identities and experiences that also experience health care bias (fatness, racial minorities, disabilities, neurodivergence, sex workers, previous incarceration, current or past drug use, etc.) Trans people have a significantly higher risk of suicide, especially youth. The single biggest protective factor against this increased risk is having supportive people in their life that respect their name and pronouns. That’s all it takes (though the more support the better of course).
So as a health care professional, what can you do to help? Here are some suggestions.“
I <3 My Chest (I love my chest): A chest health resource for trans* folk
By QMUNITY, BC's Queer, Trans and Two-Spirit Resource Centre. Dec 2014. Vancouver, BC.
"Taking care of ourselves and our chests can involve eating well, staying active and getting periodic health check-ups in a setting that feels respectful and caring. It can also mean, whenever we can, surrounding ourselves with people who are inclusive, respectful and loving to us, our gender identities and our bodies."
Download PDF here.
Discusses topics such as: binding, bras, hormones, hair removal, surgery, mental health…
My guide to caring for trans and gender-diverse patients (for doctors)
By Rainbow Health Ontario. Trans Primary Care. 2020
Guide for medical personnel caring for gender-diverse patients. “The content of this illustrated guide is based on Sherbourne’s Guidelines for gender-affirming primary care with trans and non-binary patients authored by Dr. Amy Bourns, a family physician on Sherbourne’s LGBT2SQ Health Team.”
The road to inclusion: Transgender health care in Canada
By Erin James-Abra. Published online Jun 2014. Last edited July 2014.
TransAvenue – Centre Métropolitain de Chirurgie – Blog
GrS Montreal Hospital.
Various writings, including surgery information, can be found in the TransAvenue blog of the website of the Centre Métropolitain de Chirurgie hospital in Montreal where most of the gender surgeries take place for Albertans (and other provinces except BC and Ontario).
Transgender-inclusive care
CMAJ (Canadian Medical Assn Journal), v. 191, #3, Jan 21, 2019, pg E79.
TRANSlations: Navigating HRT access in Alberta
Pivot Edmonton 2020 Cohort Zine.
Created through a collaboration between the Edmonton Men’s Health Collective (EMHC), CBRC, the Edmonton Pivot 2020 cohort, and the Albertan 2SLGBTQ+ community, TRANSlations is an original zine (online magazine of writings) made up of a collection of community testimonials and works of poetry that illuminate the diverse experiences of twelve 2SLGBTQ+ community members as they navigate Hormone Replacement Therapy (HRT) access in Alberta. TRANSlations was created to provide a basic overview of what the path to HRT might look like from a community, self-advocacy, and resiliency perspective. All participants who submitted a testimonial to this project were offered an honorarium regardless of inclusion.”
Trans patient care guide: For health professionals
Overview by the Trans Equality Society of Alberta (TESA). 2020. (Alberta)
Trans* patients — just as any other patients — may have a variety of health care needs that require the attention of a number of professionals. This overview is intended to assist health care professionals to establish a safe and welcoming environment for trans individuals.”
Understanding sexuality and gender from a Nehiyô maskihkiwiyiniw (Plains Cree Physician) perspective within Treaty Number Six Territory
By Dr James Makokis, MD, CCFP, MHSc. / CPSA (College of Physicians of Alberta) August Messenger Special Edition 2021, From Physicians. Posted August 31, 2021.
“As a physician who has long hair and also identifies as a gay-male or two-spirit person, I have often been misgendered in clinical settings during my training and in practice. The English language, Western culture and Western medicine place value on categorizing and labeling people according to sexuality, gender and appearance (including hair and hair length). I encourage my physician colleagues to explore concepts of gender and sexuality with their Indigenous patients in safe, non-judgemental and open conversations while keeping in mind that these are Nehiyô teachings and not all Nehiyawak will be aware of these teachings, nor are all Indigenous Peoples Nehiyawak.”
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US & INTERNATIONAL RESOURCES
The biology of gender, from DNA to the brain
By Karissa Sanbonmatsu. Ted Talk 2018,
“How exactly does gender work? It’s not just about our chromosomes, says biologist Karissa Sanbonmatsu. In a visionary talk, she shares new discoveries from epigenetics, the emerging study of how DNA activity can permanently change based on social factors like trauma or diet. Learn how life experiences shape the way genes are expressed — and what that means for our understanding of gender.”
Children and gender identity: Supporting your child
By Mayo Clinic Staff
“Understand the importance of talking with your child about gender identity and expression — and how to get the conversation started”
Conversations with a gender therapist
With Dr Dara Hoffman-Fox, LPC. Videos. 2014-present.
"Hi, this is Dara Hoffman-Fox, and welcome to CONVERSATIONS WITH A GENDER THERAPIST. This is where I answer questions from those who are transgender, nonbinary, and gender questioning, as well as those who love them."
Click for book link "Gender identity: A guide to discovery" or Dara's WEBSITE.
Endocrine care of transgender children and adolescents
By Daniel Evan Shumer and Adrian Araya. June 22, 2018. (YouTube video / talk)
“What we know about caring for gender non-conforming and transgender youth is changing rapidly. Learn the latest best practices in caring for transgender and gender non-conforming children and adolescents.
Daniel Shumer, MD, MPH, pediatric endocrinologist, and Ellen Selkie, MD, MPH, adolescent medicine physician, discuss best practices in the care of gender non-conforming and transgender youth. Topics covered include defining gender dysphoria, approaches to caring for children and adolescents with gender dysphoria, pharmacologic therapies used in transgender medicine, barriers to care and future directions for the delivery of care for this important patient population.’
FTM basics: Terminology
by Hudson’s FTM Resource Guide.
“This page contains definitions of a number of terms that are commonly used within FTM and transgender communities. These definitions are not meant to be the “last word” on any particular term or subject; rather, they are meant to help orient those who may be new to FTM issues. Please think of this page as one possible starting point toward knowledge and understanding of trans men’s issues. Remember that each of us is different, and the best way to learn is to be inquisitive, respectful, and to keep an open mind.”
Gender nonconformity in children and adolescents
Endocrine Society Hormone & Hormone Health Network. (US)
Editor(s): Christine Burt Solorzano, M.D., Caroline Davidge-Pitts, MBBCH. Last edited April 2019.
Health tools for patients and caregivers, provided by the Endocrine Society. Discusses terminology, hormones, gender dysphoria, etc.
How does tucking work and is it safe?
Written by Kaleb Oliver Dornheim
Medically reviewed by Janet Brito, PhD, LCSW, CST on October 17, 2017
How I help transgender teens become who they want to be
By Norman Spack, Endocrinologist Boston’s Children’s Hospital. Ted Talk video. 2013. (US)
“Puberty is an awkward time for just about everybody, but for transgender teens it can be a nightmare, as they grow overnight into bodies they aren’t comfortable with. In a heartfelt talk, Norman Spack tells a personal story of how he became one of the few doctors in the US to treat minors with hormone replacement therapy. By staving off the effects of puberty, Spack gives trans teens the time they need.”
It’s a transgenderation: Issues in transgender medicine
By Dr Rachel Levine. Jan 2017. Ted Talk video. (US)
Talk by Dr Levine at a college.
Kids in the House "The Ultimate Parenting Resource website".
"Johanna Olson, MD is a pediatrician in the Division of Adolescent Medicine at Children’s Hospital Los Angeles and Medical Director of the hospital’s Center for Transyouth Health and Development. She specializes in the care of transgender youth, gender variant children, youth with HIV, and chronic pain. Board certified in Pediatrics and Adolescent Medicine, Dr. Olson is also an Assistant Professor of Pediatrics in the Keck School of Medicine of the University of Southern California.
Parenting expert on: Gender Differences, Gender Identity, Transgender Kids, Body Image"
Defining transgender and gender non-conforming
Help for accepting a gender non-conforming child
Social transitioning for gender non-conforming children
Assessing readiness for medical puberty suppressants
Deciding when to treat a youth for gender re-assignment
Early vs. later intervention for gender non-conforming children
Efficacy, safety & side effects cross-sex hormone therapy
Financial and cultural challenges of getting care for transgender issues
Issues facing a gender non-conforming child
Issues facing the vulnerable population of gender non-conforming youth
Online support for gender non-conforming children
Pediatrician vs. specialist for treating gender non-conforming children
Selecting the right mental health professional for gender non-conforming children
Statistics & solutions for regretting gender treatment
Statistics for transgender children
Steps for treating a boy who feels he is a girl
Steps for treating a girl that feels she is a boy
The evaluation for gender re-assignment
The spectrum of gender non-conforming people
Understanding cross-sex hormone therapy
Understanding gender confirmation surgery
When parents disagree about gender non-conforming child
When parents don't support their transgendered child
Medical care for transgender youth with Dr Johanna Olson-Kennedy
Transgender School Podcast. YouTube. Episode 8. Aug 31, 2021. (US)
"You don’t want to miss this very important conversation with one of the world’s leading experts in medical care for transgender children, teens, and young adults. Dr Johanna Olson-Kennedy shared her vast wisdom and clarified so many of the common misconceptions about transgender people and their medical care.
With a patient load of over 700 transgender children, teens, and young adults and 16 years of experience in this field, Dr. Olson-Kennedy has answers to our most pressing questions related to gender dysphoria, treatment options, and much more.
Because this conversation was so rich and covered so many critical life-saving aspects of transgender care, these bullet points will give you an idea of just some of what we were able to cover with Dr Olson-Kennedy. We will be doing a part 2 with her in the future.
● Challenges with access to gender affirming medical care
● Bringing the body and brain into alignment
● Gender identity lives in the brain
● Gender is a color wheel of shades, not a binary
● Why trans care is now a political issue
● The top 5 concerns parents usually have about medical care for their trans kids ● What a visit to a physician who specializes in gender care should include
● A typical first visit with Dr. Olson-Kennedy and the importance of that first conversation
● The reality of hormones – it’s not a one-time decision & it will have the greatest positive effect on the brain, in addition to beards and boobs
● Puberty blockers are reversible "
Medical resources
LifeOutsideTheBinary website. US-based but lots of useful info.
“Transition is a unique experience which is completely different for every person, and it is important to remember that not every trans or non-binary person feels the need to adjust their physical body to better align with their identity. Some people many feel the need to have only one or a couple forms of medical intervention, while other people may want to undergo more extensive medical intervention. Your journey is entirely up to you! The purpose of this page is to present the various options available if you are interested in medical transition.”
My transgender son’s health depends on inclusive medical providers
By Leslie Lagerstrom. Transparenthood blog post. Oct 2019.
“As we walk into the urgent care clinic, my stomach begins to knot. It’s a weekend, and my son has a bloody nose that will not stop. What is a mundane visit for most people is not for us, because my son is transgender. As we check in, uncomfortable memories of previous interactions with medical professionals wash over me. We have been at this for 15 years, but we are still never sure what to expect when we visit a doctor’s office.”
Ten things transgender persons should discuss with their healthcare provider
By GLMA Health Professionals Advancing LGBTQ Equality. 2012. (US)
Top surgery considerations for non-binary folks
“People who identify as non-binary or genderqueer represent a substantial and growing population within the LGBTQ community. Despite this, healthcare practices have been slow to catch up to meet the needs of non-binary people seeking a medical transition/alignment.”
Transgender and gender-diverse individuals are more likely to be autistic and report higher autistic traits
By Simon Baron Cohen. (UK)
“Transgender and gender-diverse adults are three to six times more likely as cisgender adults (individuals whose gender identity corresponds to their sex assigned at birth) to be diagnosed as autistic, according to a new study by scientists at the University of Cambridge’s Autism Research Centre.”
Transgender health: A practitioner’s guide to binary and non-binary trans patient care
by Benjamin Vincent. 2018. (book)
“The number of people coming out as transgender continues to rise, and this book shows healthcare and medical practitioners how to deliver excellent primary and secondary care to gender diverse patients.
This guide provides accessible and practical advice on tailoring the social and ethical aspects of practice to the needs of each individual. Beyond setting out how clinical procedures should work for gender reassignment, it explains how to use language and pronouns in a respectful way, provides information on transgender services and resources, and offers insights into the challenges commonly faced by transgender people in both medical and social contexts. Based on cutting edge research and the lived experience of the author as a non-binary person, this is essential reading for all those working to meet the needs of transgender people in healthcare settings.”
Transgender resources
Written by the Healthline Editorial Team — Updated on May 29, 2020. (US)
“Healthline is deeply committed to providing trusted health and wellness content that educates and empowers more than 85 million people per month to live their strongest, healthiest lives. We believe health is a human right, and it’s vital that we recognize and understand our audience’s unique perspectives and needs so that we can provide the most meaningful health content for everyone. This transgender resource center is a reflection of those values. We worked hard to create empathetic and research-based content written and medically reviewed by members of the community. We covered a range of topics but made sure to address areas that are important to the transgender community. As with all Healthline resource pages, we plan to continually grow and revise this content.”
My transgender transition tracker:
"Track your truth with this schedule planner, med reminder, transition journal"
By Transtastic (publisher). 2020.
"Track your transition to your true self with this Transition Tracker!
Keep track of your medical information and medication; emotional, mental and physical changes; schedule and appointments with this stylish and portable 6" x 9" journal. Note unexpected side effects to your medications and be better prepared for your medical appointments with your doctor, therapist, and/or transition team! Weekly prompts guide you through your journey into LIVING YOUR TRUTH!"
The weird history of the “sex chromosomes”
By Molly Webster. Ted Talk video. 2019.
“The common thinking on biological sex goes like this: females have two X chromosomes in their cells, while males have one X and one Y. In this myth-busting talk, science writer and podcaster Molly Webster shows why the so-called “sex chromosomes” are more complicated than this simple definition — and reveals why we should think about them differently.”
What doctors should know about gender identity
By Kristie Overstreet. Ted Talk video. 2017.
“Kristie Overstreet is on a mission to ensure that the transgender community gets their health care needs met. In this informative, myth-busting talk, she provides a primer for understanding gender identity and invites us to shift how we view transgender health care — so that everyone gets the respect and dignity they deserve when they go to a doctor.”
Where’s my book? A guide for transgender and gender non-conforming youth, their parents, & everyone else
By Linda Gromko, MD. 2015.
“Linda Gromko, MD is a Board Certified Family Physician who has worked with the transgender community for nearly eighteen years. She explains the basics of gender identity, sexual orientation, puberty, puberty blockers, hormone treatments, and gender affirming surgeries. She shares years of her patients’ wisdom and practical information on getting through every day in the best way possible—from coming out to parents, to school issues, to coping with depression, to love and sex. Why is this book important? We know that transgender kids and their families need specialized information. Alarmingly, the suicide attempt rate among trans youth is close to half! This book is intended to give gender non-conforming kids some of the information they need to grow to be happy, productive, loving and loved. It’s intended to provide the information we need as parents, educators, and health care providers to do better with and for our kids.“
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