Focus On: Health and Health Care
Background information and best practices for reporting on health and health care for trans and gender-diverse communities.
A person’s health and well-being are about not only their physical health, but their mental, emotional, and spiritual health as well. Medical factors like physical illness can affect someone’s health, but so too can non-medical factors like income and social status, employment and working conditions, education, access to health services, racism, and a number of other social determinants of health.
Much is still to be learned about the ways in which a person’s trans identity interacts with these social determinants of health to impact overall health and well-being. Journalists are in a prime position to take up the torch and provide in-depth coverage on these important issues.
Health Data for Trans and Gender-Diverse People
Limited Canadian data exists around the health of trans and gender-diverse people in our country. Among the research that is out there, much of it does not differentiate between gender identity and sexual orientation, grouping everyone from 2SLGBTQ+ communities into one study group. When referring to data, make sure you check which communities are included in the research.
One of the most comprehensive sources of data specifically focused on trans and gender-diverse people is the Trans PULSE Canada study. Conducted in 2019, it surveyed nearly 3,000 people in Canada who identify as a gender other than what they were assigned at birth (characterized by the project as “trans and non-binary”).
While Statistics Canada collects health data as part of the census, most figures don’t yet offer a true snapshot of trans and gender-diverse people. For its 2021 census, Statistics Canada added separate questions on sex-at-birth and gender, giving people the chance to select an option other than “male” or “female” for the first time. A similar update has been made to the agency’s Canadian Community Health Survey.
These new questions are a positive start, and will produce more accurate, Canada-specific data that can be used by journalists—for topics related to health and other important issues.
Barriers to Accessing Health Care
Racial, cultural, religious, sexual orientation, gender identity, and socio-economic disparities have long existed in health care. But 2SLGBTQ+ people have been receiving unequal health care and treatment in a variety of ways since the beginning of the medical profession, and this has persisted despite advances in access to care, coverage for certain gender-affirming medical procedures, and HIV and AIDS prevention and treatment.
Discrimination in health care settings, including among doctors and other health care professionals, can harm 2SLGBTQ+ people, especially those who face precarious situations related to employment, housing, and other aspects of their daily lives.
Though Canada has universal health care, finding medical professionals who create inclusive spaces can be a barrier preventing 2SLGBTQ+ folks from seeking medical support. As a result, they may face health-related problems that could have been avoided with preventative care.
A Trans PULSE Canada survey from 2019 found that trans and non-binary people in Canada were almost just as likely as the general Canadian population to have a primary health care provider (81% of trans and non-binary folks versus 84% of the general population).
However, when asked whether they had experienced an unmet health care need in the last year, nearly half (45%) of trans and non-binary people answered yes, compared to just 4% of the general population. This suggests that the availability of health care is just a first step in accessibility.
According to Trans PULSE Canada data, racialized trans and non-binary people in our country rate their overall health more poorly than non-racialized folks from this community. This may be attributed to the higher rates of discrimination and instances of harassment, physical violence, and sexual assault faced by racialized trans people when compared to non-racialized community members.
To do justice to such truths, it’s essential that journalists take an intersectional approach when reporting on the lived experiences, resilience, and barriers encountered by trans and gender-diverse people when attempting to access health care.
“For people of colour and racialized people, their experience with the health care system has always been challenging and adding the trans identity to that is just another barrier.”
- Yasmeen Persad (she/her), Coordinator of The 519’s Trans People of Colour Project (TPOC) and a Trans PULSE Canada researcher
Advocating for reproductive rights
We are witnessing increasing polarization around the issue surrounding people’s reproductive rights. The media plays a key role in highlighting the problem at large and advocating for the basic human right to determine what’s best for one’s body, including taking decisions to ensure one’s reproductive health and wellbeing.
2 Spirit people, trans men, non-binary, gender-non-confirming, and gender fluid people often get left behind in these important conversations that have an equal if not greater impact on them. A lot of this stems from the misconception that only cisgender women menstruate and are capable of birthing humans, which in actuality, is not true. The reproductive rights of 2 Spirit, trans, non-binary, gender-non-conforming, and genderfluid people are under attack as well.
For journalists and media players, the conversation would be one-dimensional and incomplete if they were to miss voicing the thoughts, feelings, and insights of ALL people within our communities who are directly impacted by such bills and laws - irrespective of their sexual orientation, gender identity, or gender expression.
Patriarchy impacts everyone - including cisgender heterosexual men - and it keeps our communities othered. Don’t leave out 2 Spirit, trans, non-binary, gender-non-confirming, and gender fluid folks from important conversations. Instead, work with us to hold our institutions more accountable, and help effect change and fight sexism, homophobia, transphobia, and anti-reproductive ideology.
Key Terms for Covering Health and Health Care
These descriptions have been pulled from The 519’s Glossary of Terms and the Association of LGBTQ Journalist (NLGJA) stylebook.
Use “a person is transitioning”
Use terms like transition-related surgeries, gender-affirming surgeries, or gender-confirming surgeries (pluralize when possible)
If this information is specifically relevant to the story, use “sex assigned at birth”
Say someone “is transgendering”
Say someone is having a sex change
Say “biologically male” or “biologically female”
Error #1: Being trans requires medical treatments
A person can only be considered trans or gender-diverse after they’ve had medical treatments
A common assumption is that a person must be on hormone therapy or have had gender-affirming surgeries before they can identify as trans or gender-diverse.
What to do
A person’s medical history has no bearing on whether they should be considered trans or gender-diverse. While it’s often assumed that trans people want or have had some form of surgery, not all do or will. This may be due to personal choice, or because of the very real financial barriers to accessing some forms of gender affirming healthcare.
If and when their journey does include surgery or other forms of affirming health care, people undergo these for a variety of reasons, not the least of which is to align their physical characteristics with their gender identity.
The following sections provide further context for reporting as it relates to the Health of 2SLGBTQ+ Communities.
LGBTQ2S Inclusion Playbook
Best practices for health care environments. A long-time collaboration between The 519 and a collection of primary and community health care providers in East Toronto.
Health and Well-Being Among Trans and Non-Binary People
The first national all-ages data on health and well-being among trans and non-binary people in Canada. Data from the 2019 Trans PULSE Canada survey.
Trans PULSE COVID-19 Dashboard
An easy, interactive tool to explore key findings from the Trans PULSE Canada COVID Cohort to access the impacts of the pandemic on trans and non-binary people in Canada.
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