Hamilton board of health will debate improving health care for transgender residents

For a city its size, Hamilton is a wasteland for transgender health care resources. But the city's board of health Monday is poised to take at least baby steps toward changing that.

In an ideal world, we would have family physicians who are well versed in hormone therapy, gender transition, referrals for surgery, and psychosocial support.- Cole Gately, co-founder of the Hamilton Trans Health Coalition

The board — comprised of Hamilton's 16 city council members — will vote whether to write to the Hamilton Niagara Haldimand Brant Local Health Integration Network (LHIN) about improving transgender health resources.

The goal, says Coun. Aidan Johnson of Ward 1, is to get LHIN feedback on "immediate, medium and long-term steps" toward improving health care for transgender and non-binary patients.

By many accounts, it's needed.

St. Catharines fares better for transgender resources, in part because of the Quest community health centre, Johnson said.

And Toronto, Johnson said, "has done a lot more thinking and a lot more work around anti-transphobia and equality."

But in Hamilton, many transgender patients have difficulty even finding doctors who will prescribe them hormones or help them transition.

Just as transgender people face stigma in workplaces and ordinary life experiences, they face it while seeking out health care too, said Cole Gately, chair and co-founder of the Hamilton Trans Health Coalition. The coalition was founded with a goal of improving access to transgender health care resources in Hamilton.

Gately would like to see, for example, family physicians better educated on gender issues. He, among others, worked on the motion with Johnson.

Gately would like to see transgender health incorporated into everyday health care, not just as a specialized area that requires a separate clinic.

"In an ideal world, we would have family physicians who are well versed in hormone therapy, gender transition, referrals for surgery, and psychosocial support," he said.

Johnson has involved himself in other transgender-related issues during his first term. Earlier this year, city council passed a transgender and gender non-conforming protocol.

That outlined, among other things, that transgender people can use washrooms and change rooms that align with their gender identity. This reflected "the existing state of the law," said one lawyer, and didn't deviate from what was already happening. But Johnson said it spelled it out for everyone.

The city was forced to establish a protocol after a human rights tribunal settlement between Hamilton's transit agency and a transgender woman. In 2014, the woman tried to use the women's washroom at the Macnab bus terminal. A security guard stopped her, and she filed a human rights tribunal complaint.

After that settlement, Johnson also moved that the city start flying the transgender pride flag in June, which is Pride Month. He was also a vocal opponent when the Christian Heritage Party (CHP) placed bus shelter ads implying that the protocol would mean transgender men could enter ladies rooms.

The CHP, and local party member Jim Enos, are in the midst of a court challenge with the city now.

Working on the protocol, Johnson said, educated him on Hamilton's dearth of transgender health resources.

"One of the key things I learned and heard is the transgender community faces inequality in our regional health care system," he said.

As an example, Johnson said, he heard wait lists are "unacceptably long" for transgender people seeking health care. As a result, many travel to Toronto or Niagara for care.

At Quest, for example, the clinic has more than 1,000 regular patients, and wait times to see a doctor there are between four and six months.

By looking at how the health care system could work better for transgender residents, Johnson said, it also "opens up a broader question on equity in health care."

There's precedent for the LHIN putting money in transgender-specific health care resources. The Quest clinic in Niagara, according to its website, is largely funded by the LHIN.