Background: Many trans people who seek medical transition, particularly youth, struggle to access care in a timely manner. Frequently, specialized clinics tend serve the majority of the trans population and the capacity of these clinics ends up being overburdened by demand. Yet, the provision of gender-affirming medical care is not beyond the skillset of general practitioners and if more took up prescribing it, access could be improved.

Objectives: This study sought to understand physician perspectives on gender-affirming care for trans youth in the hopes that insights into how to encourage more practitioners to take up providing care could be gleaned. The study had two central research questions. 1) What are Canadian physicians’ perceptions, education, and knowledge base surrounding gender-affirming care for youth under the age of 18? 2)How does this differ between knowledgeable physicians who have experience with gender-affirming care and inexperienced physicians who do not?

Methodology: An anti-oppressive queer theoretical lens was applied to this study. Individual, semi-structured, in-depth, interviews were conducted with 13 physicians who had a range of experiences providing care for trans patients. The interviews were transcribed and coded for similar themes which constructed the results.

Results: Participants discussed a wide range of topics related to gender-affirming care for trans patients, both specific to youth and more general to trans healthcare broadly. Many participants argued, some with direct firsthand experience, that gender-affirming care does not need to be specialized care and can be prescribed, easily, by primary care providers. Many physicians receive little, or no education related to gender-affirming care in medical school. Despite this lack of education several participants became knowledgeable and willing to provide care to trans patients. Knowledgeable physicians frequently shared similar motivations, and accessed similar resources, in order to become willing and able to provide care.

Discussion: This study proposes recommendations for improving access to gender-affirming care for trans youth, and trans patients broadly. Improving and implementing education regarding gender-affirming care in medical schools and expanding resources for currently practicing physicians who take on trans patients. As well as framing gender-affirming care to exist within primary care practice.