Navigating Ontario’s health care system can be difficult for any patient. For trans and intersex patients, these barriers to care can be virtually insurmountable. Three local health care professionals are trying to change this with a new transgender health clinic.
A gynecologist by training, Dr. Ashley Waddington started a clinic for transgender patients at KGH three years ago after seeing an increase in patients seeking menstrual suppression at her contraception clinics. With a doctor and another gynecologist, Dr. Waddington ran the clinic once a month at Kingston General Hospital (KGH).
“As soon as the word sort of got out that somebody was seeing people for gender diversity issues, the referrals just started to pour in,” said Dr. Waddington, explaining that they were quickly overwhelmed with demand as the clinic’s popularity exploded and racked up a year-long waiting list. “It was way more than I was expecting. We couldn’t handle this because we all already had full time practices.”
After seeing the community’s need for their services, they applied for funding to hire a social worker and nurse practitioner in order to run a full-time clinic. After being granted a year of base funding and five years of additional funding from the Local Integrated Health Network, the transgender health clinic opened in the Kingston Community Health Centres.
Staffed by Dr. Waddington, social worker Kaili Gabriel, and registered nurse Heather Geddes, the clinic serves approximately 100 patients with a wide range of services, including gender-affirming medical care and treatments. The clinic offers medical transition services (such as hormone therapy) and referrals for surgical transitions (including top and/or bottom surgery).
Clinic social worker Kaili Gabriel provides free mental health counselling for anyone experiencing any kind of gender identity issue, and support to their families, parents, siblings, and children. She stated that Canadians who identify as transgender often experience a greater prevalence of mental health issues, creating a need for transgender-specific mental health services. According to a 2018 study by the Canadian Institutes of Health Research, Transgender youth in Canada are between 3.8 to 16.1 times more likely than their cisgender peers to report psychological distress, self-harm, major depressive episode, suicidal ideation, and suicide attempts.
Gabriel also helps connect preexisting resources and community organizations to create a network of support.
“I’ve been working with other local agencies to make everyone aware and create community capacity,” said Gabriel.
The clinic also assists patients in changing their sex designation on birth certificates, driver’s licenses, and OHIP cards. It became slightly easier for Ontarians wishing to change or remove their official gender markers when the province made driver’s licences with ‘X’ instead of ‘F’ or ‘M’ in the sex field available in early 2017 and removed the sex designation on Ontario health cards in June 2019.
Geddes sees about three new patients a day and up to five follow up patients. She said she left a “very secure” job to come work as the clinic’s full time nurse, but the risk paid off.
“It’s the best job I’ve ever had,” Geddes said. “You see how happy you’re making people.”
The clinic is planning to work with a family doctor at Queen’s family health team to start a primary care clinic for gender-diverse people, but also provides education and resources about transgender health to local doctors.
“One of the challenges is that there’s not a lot of providers in the city who are comfortable with this care,” said Waddington. “They’ve never done any training in their residency or medical school.”
While transgender patients sometimes require special kinds of care related to transitioning or mental health, they often have many of the same day-to-day health needs as cisgender patients.
“This doesn’t have to be such specialized care. This is something that other primary care providers could do and feel comfortable with,” Waddington explained. “We’re also working on making this an educational opportunity.”
The transgender health clinic is located at the Kingston Community Health Centres at 263 Weller Avenue. To learn more or book an appointment, contact the clinic by email at [email protected] or by phone at 613 542 2949 ext. 1166.