Youth and Family Experiences at the CHEO Gender Diversity Clinic
As facilitators of SAEFTY we have heard from trans and gender diverse young people in Ottawa for several years about the significant barriers and lack of gender affirming care that many people experience when accessing transition related medical care in the Diversity Clinic at the Children's Hospital of Eastern Ontario (CHEO), which is the only place for children and youth to receive this care in Ottawa.
In the summer of 2018, in response to our experiences and those that were shared with us, we conducted a community based participatory action survey to collect information about children, youth, and families' experiences accessing gender affirming medical care at CHEO, along with community recommendations and feedback to the clinic.
“Without affirming care when I needed it most, I am not sure if I would be alive. I was never suicidal but I just cannot imagine being alive without hormones and surgery.”
We received over 50 responses from trans and gender diverse youth and their parents and caregivers. We have compiled these results and recommendations into a report, which is available to download below. We shared this report with the CHEO diversity clinic staff in January of 2019, prior to releasing it publicly. We were able to have two meetings with staff in the clinic, as well as one meeting with Alex Munter, president and CEO of the hospital, to discuss the results and our recommendations. The clinic staff indicated that they were in the process of working to resolve some of the issues we identified, including incorrect use of patients’ legal names. Some staff in the clinic indicated that the report was helpful for them to improve the care that they provide, however the team was unwilling to continue meeting with us after our second meeting so it is unclear what changes have been made in the clinic since then.
“[I was told] that I was ‘too fluid’ for hormone treatment. At that point, I was very scared that I would never be able to receive hormones […]”
Access to transition related medical services are vital for many young trans and gender diverse people, however many people have negative experiences when trying to access this care. Some of our key concerns based on data collected from the survey include clinicians asking children and youth invasive and leading assessment questions that make young people uncomfortable and are perceived to gatekeep their access to medical care, medically unnecessary mandatory chest and/or genital examinations which violate young people's boundaries and do not give them the option to refuse consent, and excessive numbers of assessment appointments leading to long wait times for urgently needed care.
These issues are not exclusive to CHEO, but are part of a longstanding systemic exclusion of trans communities and existing common practices embedded with a lack of understanding of our communities’ needs. Nevertheless, we know that there are other clinics doing important work to provide more appropriate gender affirming care. We hope that by sharing our results and recommendations, and initiating these conversations, the voices of trans and gender diverse children and youth and their families and caregivers will be taken seriously in conversations about their health care, both locally and internationally so that trans and gender diverse young people can receive the most gender affirming services possible.
We are always open to feedback and would love to hear about your recent experiences in the clinic since our survey was completed! To share your experiences with us or for more information or support about navigating transition related health care in Ottawa you can send us an email or contact us via Facebook or Instagram.