Medical experiences for transgender Nova Scotians need to improve, says study

As some transgender Nova Scotians apply to change gender markers on their birth certificates for the first time, some say that's just one part of the challenge of improving health care experiences. 

Final changes to Bill 82 were legislated last week. The Vital Statistics Act now allows anyone born in Nova Scotia to more easily change gender markers on their birth certificates from either F to M or M to F. 

"It was a big breath of air that was like, finally. Finally this has changed," said 20-year-old Jessica Durling.

Durling is now awaiting a professional signature required for her gender marker application. Meanwhile, results of a Dalhousie study were released to coincide with a Canadian Professional Association for Transgender Health conference being held in Halifax this week. 

The study, based on 370 respondents, says just over half of transgender people — 51.1 per cent — report having negative experiences with medical professionals in Nova Scotia. 

Many of those experiences, Durling says, stem from birth certificate information. 

"Hospitals are definitely a very scary place for people in the community. You definitely hear a lot of what could be considered horror stories."

She says it's common to hear about people getting misgendered or deadnamed — which is when someone is called a name they no longer go by.

"Just awful, awful experiences," Durling says.

Bridging experience gaps

Changing birth certificate gender markers will do some good in this area, Durling says. But she believes educating medical professionals about conduct is equally important. 

Dr. Jacqueline Gahagan, the study's lead investigator, agrees. 

"The physician may not have any experience with preoperative trans clients even where gender markers would indicate a patient they're seeing identifies as male," she said. 

Accurate paperwork is important for client histories, Gahagan says, but many health care providers "still require more training and cultural safety training" when it comes to creating positive and comfortable environments.

Gahagan is now working to create online and offline training modules for Dalhousie medical students based on the research.

"The idea is to look at what are the ways LGBTQ folks promote their health, and we've asked them specifically questions about that. And what are the issues health providers face while promoting the health of their LGBTQ clients. We're trying to bridge the experiences." 

Durling says she's not surprised at the negative statistics, but was hopeful after learning that 27.5 per cent of trans or gender-variant respondents reported a positive experience in the study.

"This just goes to show the future," she said. "And hopefully the future will be a brighter place and those numbers of discrimination, of mistrust with the medical environment — hopefully, trans people can have more positive experiences."