Gender-affirming health care in Canada needs to be improved, according to articles published in the July edition of the Canadian Medical Association Journal (CMAJ.ca).
The main article, a research paper authored by several Canadian physicians and researchers, said transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care. This would include stigmatization and health inequities, said the article.
"Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care professionals," said the article.
The article was authored by Hilary MacCormick, Les T. Johnson, Drew Burchell, Allana Munro, Gianni R. Lorello, Ronald B. George and M. Dylan Bould. They are associated with hospitals and universities in Halifax, Toronto and Ottawa.
The main article was titled: Lived experiences of transgender and nonbinary people in the perioperative context: a qualitative study.
Their study consisted of interviews with TNB adults who underwent surgery in Canada within the previous five years. The researchers said they interviewed 21 individuals who gave their impressions of the health care they received. It was not all bad. It was not all good.
"Participants described positive and negative health care encounters that led to stress, confusion, and feelings of vulnerability. Major themes included having to justify their need for health care in the face of structural discrimination; fear and previous traumatic experiences; community as a source of support and information; and the impact of interactions with healthcare professionals," said the article.
The authors interpreted the data to indicate that participants had described "barriers to accessing care, struggled to participate in shared decision-making, and desired trauma-informed care principles."
The authors wrote that the patients also described strength in community and positive interactions with healthcare professionals, although barriers to accessing gender-affirming care often overshadowed other aspects of the perioperative experience.
"Additional research, increased education for health care professionals, and policy changes are necessary to improve access to competent care for TNB people," the authors also stated.
Barriers persist
In the conclusion to the report, the authors said that barriers persist to accessing safe, inclusive perioperative care for TNB people in Canada.
The authors said in many cases patients were left to self-manage their care and to educate health care providers. The authors said there is a need for more in-depth and nuanced discussions for TNB care in Canada.
"Future research on the development of role-specific educational content and competencies should incorporate an explanation of the various roles within the perioperative team and involve direct input from TNB community members," said the authors.
The full text of the article can be found online here.
The most recent CMAJ edition also included an editorial commentary on the need to step up the level of care for transgender and non-binary individuals in Canada.
That commentary was titled: Compassion need not be a scarce resource in health care for transgender and gender-diverse people.
Len Gillis covers health care and mining for Village Media's Sudbury.com.
