Access Barriers Among Transgender and Gender Diverse Youth Seeking Gender-Affirming Care in Canada: A Literature Review
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Date
2024-05-15
Authors
Furness, Gillian
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Abstract
Introduction: There are increasing numbers of Canadian youth who identify as genders different from their assigned sex at birth. As a result, healthcare providers are encountering more transgender and gender diverse (TGD) youth seeking gender-affirming healthcare. Unfortunately, due to the effects of gender identity-related stigma, as well as distress related to the development of secondary sex characteristics during puberty, TGD youth often have complex medical, psychological, and social needs, and face high levels of social adversity, adverse mental health outcomes, substance use, and suicidal ideation. Research provides increasing evidence that access to gender-affirming care (GAC) is crucial in improving the health and social functioning of TGD youth. Unfortunately, many Canadian TGD youth are unable to access the GAC that they need, due to numerous provider, patient and systemic barriers. Objectives: The purpose of this literature review is to identify the barriers that Canadian TGD youth face when accessing GAC, and to investigate possible solutions that can be implemented within the healthcare system to improve access to GAC for this population. Additionally, this literature review will investigate how Physician Assistants (PAs) may have a role in improving this population’s access to GAC. Methods: A literature search using PubMed and Scopus databases was performed using key terms pertaining to access barriers to gender-affirming care among TGD youth in Canada. Seven articles were found to meet the inclusion criteria and were analyzed in this literature review. Results: Seven studies explored the challenges that TGD youth in Canada experience when accessing gender-affirming care. Six studies investigated potential modifications that may be implemented to improve accessibility of GAC for TGD youth in Canada. No research was found concerning how PAs may assist in the provision of GAC for TGD youth in Canada. Conclusion: The barriers to GAC for TGD youth in Canada identified in this literature review concern delayed access to care, challenges related to systemic health system issues, lack of provider knowledge or sensitivity, and financial constraints. Strategies to improve access to GAC for TGD youth include increasing training and knowledge of all providers in GAC; advocating for policy changes to make GAC more accessible; and requiring staff of medical facilities to undergo gender-sensitivity training.