What does it mean to be transgender?
Being transgender is not a pathology. It’s an identity. When a baby is born, we assign them a gender based on their genitals. But sometimes a person’s identity and how they feel in their head and heart doesn’t align with the label. That’s what being trans is. It means that your gender identify does not align with the identity someone else assigned to you.
Answers to your most asked questions...
What is the need for a transgender youth clinic?
Across the city and province there are limited health services for transgender youth under 18 seeking gender-affirming support and medical therapy. Since opening in 2013, referrals to the SickKids Transgender Youth Clinic have surged. The Clinic now receives between 20 to 30 new referrals per month for transgender youth from across Ontario. With capacity for only 14 new assessments per month, there is a wait list of approximately one year despite ongoing clinic innovations to manage wait times.
What is the vision of the SickKids Transgender Youth Clinic?
To provide care to transgender youth and to remove barriers so they can access the gender-affirming care they need more easily—not just at SickKids, but also in their home community and in the wider health-care system, which we can support through education and capacity building initiatives.
SickKids provides inclusive, non-judgmental care for youth under 18 years of age and has access to a range of different experts who collaborate to deliver gender-affirming care as an integrated team. Importantly, the team is trained to provide developmentally informed care—care that recognizes youth often need extra support to open lines of communication with their parents, react to news, make decisions and navigate a complex system that is not always transfriendly.
Is the SickKids clinic the only clinic of its kind?
No, there are other hospital-based clinics. There is one at CHEO in Ottawa and another at McMaster in Hamilton and now a couple are being started at community sites. But the model of care is different in every clinic and in every province. SickKids has one of the largest inter-professional clinics, which means we provide youth with access to a range of expertise.
What are the options for patients once they are seen at the Clinic?
The clinic is committed to offering personalized care tailored to each individual youth. For some, puberty/hormone blocking is a first step. This is a reversible treatment that puts physical changes associated with puberty on pause and gives patients and their families time and space to figure out the path they want to take. For those who make the decision to move forward with gender transition, the next step is usually hormones that start a second puberty in the direction the youth wants. Many of the youth we see eventually progress to wanting surgeries. We don’t do surgeries here, but provide links to further information about this process, and we help them to complete the application forms.
What's the impact of providing transgender youth with access to the Clinic?
When youth have access to the Clinic, what we see most often is that they open up, blossom in front of us, and grow into themselves. They start to see a future they’re excited about and they make plans for school, careers and family that they may not have been able to visualize before being affirmed for who they are. We also see many youth reconnect with their caregivers because they are able to overcome the fear of what will happen when they speak their truth and open lines of communication.
What's the impact of not having access to this clinic?
From the time a youth discloses their identify to the time they get care—a period that can last over a year—youth are at the highest risk for self harm and suicide. They have revealed who they are, but often don’t get the support they need from those around them. Some youth are kicked out of their homes. Many stop going to school, or they go to school but won’t go to the bathroom. During puberty, they can’t stop their body from changing in ways that are deeply distressing to them. Those between the ages of 14 and 18 have a five times greater risk of suicidal thoughts than their peers, with almost two-thirds having seriously considered suicide and three-quarters reporting self-harm. In short, the lack of services and long waitlists put youth at high risk. Improving access to this clinic, is a lifeline.
What can young people do if they are struggling or have questions about their gender identity?
Tell somebody and try to find some support. There are online communities. There's YouthLine. There’s Kids Help Phone. And there’s hope. It may seem overwhelming, but there are a lot of people that have been through this and have been successful. You are not alone. It may feel like it, but you're not. There are people that can help you.
What can people do to help?
For those who are already supportive, spread the word, and role model acceptance. Don't make assumptions. Ask youth how they wish to be addressed, and correct yourself if you make a mistake. For those who are uncomfortable, remember just because you don’t understand something, doesn’t mean it’s wrong. We all want youth to be safe and healthy. That’s what parents want. That’s what we want, too. That is the common ground we should try to build upon.
LGBT Youth Line is a Queer, Trans, Two-Sprit youth-led organization that affirms and supports the experiences of youth (29 and under) across Ontario. It offers confidential and non-judgmental peer support through telephone (1-800-268-9688), text (647-694-4275) and chat services. Get in touch with a peer support volunteer from Sunday to Friday, 4:00PM to 9:30PM.
In Canada, children and teens in distress can contact Kids Help Phone on KidsHelpPhone.ca or call 1-800-688-6868.
Referrals to the Transgender Youth Clinic should come from a primary health-care provider and be submitted online. If a youth does not have a primary health-care provider there are other ways to get a referral. For more information, please see the Clinic’s webpage.
For more information about how to support the clinic, please contact Kevin Goldthorp at Kevin.Goldthorp@sickkidsfoundation.com