Gender-affirming care is “health care that holistically attends to transgender people’s physical, mental, and social health needs and well-being while respectfully affirming their gender identity.” Providing gender-affirming care means making health care comfortable, effective, equitable and accessible for gender-diverse and transgender patients – including using a patient’s correct name and pronouns, providing gender-affirming hormone therapy and ensuring that those who need gender-affirming surgery are able to access the procedures without undue hardship (such as excessive evaluation requirements, long referral and surgical wait times, and needing to travel out of province for gender-affirming surgery).

Why is GAC important?

Research has shown that transgender people are at higher risk of poorer health outcomes, due to the individual and systemic discrimination they may experience when navigating the health-care system. Because transgender patients are more likely to experience discrimination when they seek health care, they are often reluctant to do so. It’s also more likely they won’t get the care they need when they do seek help from a health-care professional, which means that diagnoses and treatments can be needlessly delayed, and treatment outcomes are worse.

Some barriers are starting to lift. On July 20, 2022, the provincial government announced that people requiring gender-affirming surgery are no longer required to get letters of support from two specialists. Previously, patients would wait up to 18 months to see a specialist. This will help Nova Scotians receive more timely care, and also free up health care resources for other areas.

Equipping the health-care system to offer gender-affirming care in all health-care settings will mean that gender-diverse and transgender patients are more likely to have good health-care experiences, which leads to better health outcomes. While some physicians, like Halifax’s Dr. Sue Atkinson, are providing gender-affirming care in the province, it’s currently still difficult to access gender-affirming care in Nova Scotia, with barriers and delays the norm.

Ensuring everyone who needs it has access to gender-affirming care is an important part of making health-care equitable and accessible for all Nova Scotians. In March 2022, Doctors Nova Scotia endorsed a gender-affirming care policy and recommendations put forward by Gender Affirming Care Nova Scotia, an organization seeking to “remove barriers and add protections for those requiring GAC, ensuring that everyone who needs care can get it.” The policy is a comprehensive overview of approaches and supports needed in the province. It’s supported by community and health-care organizations.

The recommendations include increasing the number of physicians trained in providing gender-affirming care in both primary care and surgical settings, with training provided during medical school and throughout physicians’ careers. Other steps include ensuring that gender-affirming care components like hormone replacement therapy management and gender affirming surgeries are funded and physicians who provide gender-affirming care are properly compensated.

Although endorsing a policy is a small measure, it’s an important first step toward ensuring that all Nova Scotians are able to receive the health care they deserve.

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