Doctors already in short supply in Alberta. Now, imagine trying to find one who's gay

Finding a family doctor is a challenge for most Albertans. The number of physicians in the province taking new patients has dropped by half since 2020.

For those who have unique medical needs, it can be an even greater challenge to find a doctor who understands the particular best practices for working with a given community.

For Dr. David Gaunt, a gay doctor in Calgary, seeing members of the LGBT community struggling to find a family doctor is disheartening because he knows the demand for queer doctors and physicians who are allies of the queer community is huge. 

He estimates his own practice is 10 or 20 per cent LGBT people. It's currently closed to new patients, with a 90-person wait-list. Gaunt says he doesn't know any doctors who serve the community currently taking patients.

"I get questions every day from people asking, 'I have these friends that are looking for a family physician that would love somebody who's gay or at least gay friendly.'"

Gay doctor means fewer explanations

Having a health-care provider who is of the same identity or at least is well versed in the needs of people with that identity means not having to explain many aspects of LGBT life and can help remove the barriers to the specific health care LGBT patients' needs that can exist in a conventional practice, he said.

While reporting this story, CBC News attempted to find a gay GP in Calgary who was accepting patients, using Google and other doctor-search tools, but couldn't find any.

"Orchiectomies, vaginoplasties, HRT, blockers, electrolysis, laser — these are life-saving procedures," said Kim Fuery, a trans woman and advocate for trans rights from Airdrie, Alta., who came out in 2021.

"But they're treated like they're elective or like a trivial [concern]."

She says the longer people delay seeking help for gender dysphoria — a sense of unease one may have because of a mismatch between their sex assigned at birth and their gender identity — the harder the toll it takes on those experiencing it. 

Fighting with a physician who doesn't understand the issue may not only delay care but also exacerbates trauma, she said.

Searching for right physician is exhausting

When Fuery initially came out, she wasn't sure she would be able to work with her family doctor at the time. She knew her doctor would be supportive, but she didn't know how much she would be able to rely on her for everything she needed after a disagreement over a previous diagnosis.

She began a search for another physician but had trouble finding someone appropriate until she found Skipping Stone, a service in Calgary that links trans people with care providers.

The process of finding the right care provider and getting the appropriate treatment requires an enormous amount of effort and self-advocacy, Fuery said. She considers herself lucky because she was able to find the care she needs.

"I have a lot of energy for this stuff, but it is exhausting to have to do the emotional labour," she said. "I'm equipped to do it, but it's a lot. And then I'm reminded some days, what is it like for the people who are not equipped to do this? What is that nightmare like?"

Sexual health for gay men

Members of each group represented in the LGBT acronym each have their own particular health concerns. 

For gay men, those concerns often relate to sexual health.

Sexually active gay men often have more interaction with the medical system, whether it is for regular screening for sexually transmitted infections or maintenance of PrEP,  a pill regimen that prevents one from contracting HIV if taken daily.

Gaunt says having a gay doctor can make it easier for patients to disclose health information and behaviour-based sexual practices that can affect the type of health care provided.

"I think it really comes down to comfort," he said.

A gay doctor or one familiar with the health concerns of the gay community would also know there are STI testing methods unique to gay men, and unique ways that gay men practice sex that might require additional tests, something that's not taught in medical school. 

"I'll find little ways to kind of disclose or at least help my patients feel comfortable sometimes, when I sense that little bit of apprehension, because I know a lot of us grow up feeling like we have this big secret," he said.

Patients are often the educators

Non-gay doctors don't have the same ability to relate to those experiences and may need to be educated about gay health issues. 

Often, it is the patients having to do that educating about specific needs, such as PrEP regimens.

Some of those who are interested in PrEP but can't find a doctor or don't want to have to spend time educating physicians about the regimen end up turning to services that offer HIV prevention care remotely. Consultations happen via a web portal and over the phone, and medications are delivered to a patient's door.

As more health care moves online, the options for those who may not have direct access to LGBT-focused primary care physicians are increasing.

And for trans people with doctors willing to learn, knowledge and medical education in that area is improving, Gaunt said.

"Now, there's actually really great primary practice guidelines that are available for all family doctors to consult where it shouldn't be as daunting a process as it is."