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Abstract

Transgender, non-binary, and genderqueer people face high levels of discrimination, stigma and violence. Recent surveys indicate that transgender people represent approximately 0.5% of the population, and this number is expected to grow as people feel more comfortable expressing their gender identity. In the political sphere, recent federal legislation has granted protection against the discrimination of transgender people in Canada. Transgender individuals comprise a diverse group with specific and varied social, medical and psychological needs. Transgender people can experience high rates of distress and suicidality. Almost half (43%) of transgender people have a history of attempting suicide. Suicide risk is highest when experiencing transphobia and when waiting to transition. Rates of suicidality can drop markedly once transition has been completed. Some transgender individuals choose hormone therapy or gender reassignment surgery. Currently, candidates for hormone therapy must demonstrate a consistent and persistent gender-variant identity that meets criteria for gender dysphoria as categorized by the DSM-5. Within the health care setting, transgender people have been underserved and often experience discrimination. This is may be due to the absence of training about transgender health in health professional education. Historically, transgender people’s needs for hormone therapy were served exclusively by endocrinologists. More recently there has been a shift in the duty of responsibility toward community physicians. Given the historical context of marginalization of this community, their diverse health needs, and the shift of medical care from specialists to primary care physicians, it is important to examine the experiences of transgender individuals within the current Canadian context and to explore the experiences of the health care providers who treat them.

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