Among trans and gender diverse young people in Ottawa, it has been frequently discussed for several years that many people experience significant barriers and a lack of gender affirming care 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.
Last summer, in response to these experiences that young people and families in our communities have shared, 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.
We received over 50 responses from trans and gender diverse youth and their parents and caregivers and have compiled these results and recommendations into a report, which we have shared with staff in the clinic.
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.