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The Ontario Human Rights Code ensures equal treatment regarding membership in trade unions, occupational associations, or self-governing professions without discrimination based on gender identity or expression.
Trans individuals have the right to fair treatment within vocational associations.
Taylor, A.B., Chan, A., Hall, S.L., Saewyc, E. M., & the Canadian Trans & Non-binary Youth Health Survey Research Group. (2020). Being safe, being me 2019: Results of the Canadian trans and non-binary youth health survey. Vancouver, Canada: Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia. https://apsc-saravyc.sites.olt.ubc.ca/files/2020/12/Being-Safe-Being-Me-2019_SARAVYC_ENG_1.2.pdf
Executive Summary
The 2019 Canadian Trans and Non-binary Youth Health Survey provides valuable insights into the experiences of trans and/or non-binary youth across Canada. Conducted by researchers from various universities and community organizations, the survey collected data on health, social challenges, and protective factors among youth aged 14 to 25.
Key Findings:
Gender Identity and Expression:
50% of surveyed youth are living in their felt gender all the time, a significant increase from 2014.
However, the majority do not have their correct gender listed on identification cards and records.
Hormone Use:
44% of surveyed youth have taken hormones to affirm their gender.
Healthcare Access:
43% of youth missed out on needed physical healthcare in the past year.
71% did not receive needed mental health services.
Emotional Distress:
63% of youth reported experiencing severe emotional distress.
Supportive families, safe schools, and legal name changes were associated with lower rates of severe emotional distress.
Sexual Assault:
More than 1 in 4 youth (28%) reported being physically forced to have sex against their will, a significant increase from 2014.
Self-Harm and Suicide:
64% of youth reported self-harming behavior.
64% seriously considered suicide within the past year.
Supportive families and safe schools were associated with lower rates of suicidal thoughts.
Discrimination:
70% of youth reported experiencing some form of discrimination in their lifetime.
Discrimination was commonly based on sexual orientation, sex, physical appearance, or age.
Avoidance Behavior:
74% of youth avoided public washrooms due to fear of harassment or being outed.
Support Networks:
Youth were most likely to ask their trans friends (92%) to use correct names and pronouns, followed by non-trans friends (85%).
Methodology:
The survey included questions from the 2014 survey and new questions relevant to current youth experiences.
It was conducted online from November 2018 to May 2019, with youth aged 14 to 25 across Canada.
Youth were recruited through various channels, including social media and youth organizations.
The survey was anonymous and took up to 45 minutes to complete.
The findings highlight the urgent need for inclusive policies, research, and interventions to support the health and well-being of trans and/or non-binary youth in Canada.
Ethnic & Cultural Background:
Approximately 74% of surveyed youth identified as White, while about 12% identified as Indigenous.
Few participants identified with other ethnic backgrounds, with less than 1% identifying as Korean.
About 15% of youth checked more than one response option for their ethnic or cultural background.
New Canadians:
The majority of youth (91%) were born in Canada, and 90% had lived in Canada their whole lives.
Approximately 2% of youth were recent immigrants, having lived in Canada for two years or less.
Gender Identity:
Youth were asked about their gender identity, with 80% selecting more than one option from a list of 16 identities.
Several youth also provided write-in responses, including terms like agender, questioning, and androgynous.
The most common gender identities selected were non-binary (43%) and transmasculine/man/boy (42%).
Living In Felt Gender:
Half of surveyed youth (50%) reported living in their felt gender all of the time, a significant increase from 2014.
About 14% were not living in their felt gender at all in 2019, a decrease from 2014.
Youth in British Columbia were most likely to be living full-time in their felt gender (56%), while those in the Prairie Provinces were most likely to be living in their felt gender part-time (44%).
Legal Name:
The majority of youth (78%) expressed a desire to change their legal name, but only 30% had done so.
This marks a significant increase from 2014 when only 21% of youth had changed their name.
Youth in Quebec were most likely to have changed their legal name (49%), while those in the Prairie Provinces were least likely (17%).
Older youth aged 19 to 25 were more likely to have changed their name (35%) than younger youth.
School Connectedness:
School connectedness refers to how students feel about their school environment, including their sense of belonging, safety, and support from teachers and staff. It is an important aspect of youth development, as school is where most young people spend a significant amount of their time.
Measuring School Connectedness:
Survey participants were asked to indicate their level of agreement with statements regarding caring/respectful teachers and staff, feelings of safety, and overall happiness at school. By analyzing their responses, researchers could determine the level of school connectedness among trans and/or non-binary youth.
Findings:
Trans and/or non-binary youth generally reported feeling connected to their schools. The majority of respondents agreed or strongly agreed with statements indicating that they feel part of their school, are happy to be there, and perceive fair treatment from teachers and staff. They also feel safe in their school environment and believe that teachers and other staff members care about them and expect them to do well.
Impact on Mental Health:
Feeling connected to school has a positive relationship with mental health outcomes. Trans and/or non-binary youth who reported higher levels of school connectedness were more likely to report good or excellent mental health. This suggests that fostering a supportive and inclusive school environment can have significant benefits for the mental well-being of trans and/or non-binary youth.
Identification Cards and Records:
Identification cards and records play a significant role in the lives of trans and/or non-binary youth, as they often do not accurately reflect their gender identity or expression. This discrepancy can lead to various challenges and negative experiences, as highlighted by the survey findings:
Consequences of ID Mismatch:
Verbal harassment: 16%
Asked to leave: 6%
Attacked/assaulted: 2%
Denied services or benefits: 13%
None of these problems/never happened: 48%
Home Life:
Who They Live With:
Birth mother: 54%
Birth father: 38%
Brothers/stepbrothers: 27%
Sisters/stepsisters: 22%
Alone: 11%
With own children: 1%
Running Away:
Never: 85%
Once: 9%
Twice: 3%
3 to 5 times: 3%
More than 10 times: 1%
Feeling Safe at Home:
Often: 75%
Sometimes: 19%
Rarely: 5%
Never: 1%
Government Care:
Foster home: 5%
Group home: 4%
Custody care: 6%
Going to Bed Hungry:
Never: 65%
Sometimes: 29%
Often: 5%
Always: 1%
Key Insights:
Identification Challenges: Many trans and/or non-binary youth face difficulties due to ID not matching their gender identity or expression, including harassment, denial of services, and assault.
Home Life Struggles: While most youth live with family members, a significant percentage experience challenges such as running away, feeling unsafe at home, and experiencing government care.
Food Insecurity: A notable portion of trans and/or non-binary youth experience food insecurity, with some frequently going to bed hungry.
Physical Health:
Self-Reported Health Status:
Excellent: 4%
Very good: 19%
Good: 38%
Fair: 29%
Poor: 9%
Chronic Physical Health Conditions:
Have chronic conditions: 42%
No chronic conditions: 58%
Sleep Habits:
Not getting enough sleep on weeknights: 73%
Often or always have trouble sleeping: 73%
Do not wake up rested: 79%
Participation in Physical Activities:
Never participate: 68%
Participate less than once per week: 12%
Participate 1-3 times per week: 16%
Participate 4 or more times per week: 4%
Injury Prevention:
Wearing a Helmet:
Always wear a helmet while riding a bike: 40%
Often wear a helmet: 20%
Never wear a helmet: 17%
Rarely wear a helmet: 17%
Wear a helmet only when an adult makes them: 6%
Seatbelt in Cars:
Always wear a seatbelt: 86%
Never wear a seatbelt: 1%
Key Insights:
Physical Health: A significant portion of trans and/or non-binary youth report fair or poor physical health, and many have chronic health conditions.
Sleep Habits: Most youth are not getting enough sleep on weeknights, often experience trouble sleeping, and do not wake up feeling rested.
Participation in Physical Activities: Many youth do not participate in physical activities regularly, which is essential for maintaining good health.
Injury Prevention: While most youth wear seatbelts in cars, there's a significant portion who do not always wear helmets while riding bikes or other vehicles, posing potential injury risks.
Access to Care:
Physical Health Care:
Reasons for not accessing needed care:
Thought or hoped the problem would go away: 75%
Afraid of what the doctor would say or do: 51%
Had negative experience(s) before: 48%
In the past 12 months, 43% of youth did not get physical health care they felt they needed.
Mental Health Care:
Reasons for not accessing needed care:
Thought or hoped the concern would go away: 71%
Afraid of what the doctor would say or do: 51%
Had negative experience(s) before: 49%
In the past 12 months, 71% of youth did not access mental health services when needed.
Hormone Therapy:
Ever taken hormones to affirm their gender: 44%
Most received hormones through a prescription from a specialist (68%) or a family doctor/general practitioner (53%).
Reasons for not starting hormones:
Not planning on taking hormones: 20%
Still deciding if taking hormones was right for them: 36%
Having trouble finding a doctor to prescribe hormones: Reported by some youth.
Unsupportive parents: Reported by some youth.
These findings underscore the challenges trans and/or non-binary youth face in accessing appropriate health care, including physical and mental health services, as well as hormone therapy. Barriers such as fear of judgment from healthcare providers, past negative experiences, and lack of access to supportive environments contribute to these challenges. Efforts to improve access to gender-affirming care and mental health support for this population are crucial.
Surgery:
Readiness assessments for gender-affirming surgeries:
23% of youth had completed their readiness assessment.
15% had been referred for an appointment or were waiting for their appointment date.
Difficulty accessing referral for assessment:
56% reported difficulty.
Types of surgeries reported by youth:
Chest surgery (95%)
Vaginoplasty (30%)
Hysterectomy or oophorectomy (24%)
Phalloplasty (4%)
Metoidioplasty (2%)
Types of surgeries youth would like to have in the future:
Hysterectomy or oophorectomy (60%)
Chest surgery (58%)
Vaginoplasty (46%)
Mental Health:
Self-reported mental health:
Poor: 45%
Fair: 39%
Excellent or good: 16%
Chronic mental health conditions:
88% of youth indicated having a chronic mental health condition.
Emotional distress:
Average overall score for emotional distress: 14 (above the cutoff of 13 for severe emotional distress).
63% of youth reported severe emotional distress.
Factors contributing to emotional distress:
Violence exposure such as bullying and sexual harassment.
Protective factors:
Feeling safe in their own home, having their legal name changed, feeling connected with their family, feeling safe at school.
Substance Use:
Tobacco use:
Most youth had not smoked cigarettes (84%) or e-cigarettes (85%) in the past 30 days.
Majority started smoking cigarettes at age 17 or older (39%).
Majority did not try to quit smoking in the past year (54%).
Alcohol use:
66% of youth drank alcohol in the past month.
Majority did not start drinking until they were at least 14.
Regional differences:
Youth from Quebec were more likely to report using alcohol in the past month (69%).
Youth in British Columbia were more likely to have drunk alcohol once or twice each week (20%).
Consequences of Alcohol/Drug Use:
Negative consequences experienced as a result of alcohol/drug use:
Most common: being told they did something they couldn’t remember (18%), passing out (14%), family arguments (8%).
New in 2019: getting injured (9%), having sex when they didn’t want to (8%).
Least common: getting in trouble with the police (2%), seeking treatment for alcohol/drug abuse (2%).
Regional differences:
Prairie Provinces: Most likely to have passed out (23%) or been injured (10%).
Quebec: More likely to have used alcohol/drugs without negative consequences but more likely to have experienced changes in schoolwork/grades (8%), damaged property (8%), or had sex when they didn’t want to (10%).
Sexual Health:
Sexual experiences reported by youth:
Oral sex: 60%
Anal sex: 31%
Genital sex: 50%
Age at first sex:
44% were 17 or older.
Number of sexual partners:
24% reported one partner, 15% two partners, and 60% had three or more partners.
Contraceptive use at last sex:
68% did not use a condom or other latex barrier.
47% did not use any method to prevent pregnancy.
Condoms were the most common method used (25%).
Safety and Violence:
Feeling safe at home:
Approximately 25% of youth did not often feel safe in their own home.
In the past year, 10% experienced physical violence by a family member, and 17% witnessed violence in their family.
Romantic Relationships and Dating Violence:
30% of youth who have been in a dating relationship had been physically hurt by a date.
Safety at School:
Among youth currently attending school, varying percentages reported feeling safe in different locations: library (52% always), classroom (29% always), getting to and from school (29% always), washroom (13% always), changing rooms (7% always).
Safety in the Community:
Most youth feel safer in their neighborhood during the day (68%) than at night (29%).
35% reported being physically threatened or injured in the past year, 66% had been bullied, taunted, or ridiculed, and 9% had been threatened with a weapon.
Sexual and Family Violence:
Sexual Violence:
Verbal sexual harassment experienced by 63% of youth in the past year.
Physical sexual harassment experienced by 34%.
46% reported being sexually abused, with 14% by a family member and 31% by someone outside their family.
28% reported being physically forced to have sex when they did not want to, which is an increase from 2014 (23%).
Cyber Safety and Cyberbullying:
More than 1 in 3 youth have been asked for personal information over the internet (40%), felt unsafe online (39%), or experienced cyberbullying (31%).
Avoiding Situations for Safety:
Trans and/or non-binary youth often avoid certain situations or areas of school or the community to protect themselves from potential harassment.
Commonly avoided locations include public washrooms (74%), gyms or pools (66%), school washrooms (55%), and school locker rooms (55%).
Supportive Relationships:
Helpful Support:
Friends were most likely to be identified as helpful (88%), followed by mental health counselors (77%), and youth workers (76%).
The Prairie Provinces were least likely to find friends helpful (75%), and youth in Ontario were most likely (92%).
Support Available When Needed:
Most of the time, the majority of youth have someone they can count on to listen when they need to talk (56%), confide in (53%), and love them (51%).
Family Connectedness:
Youth reported their mother figure cared more about them than their father figure, with 50% reporting their mother figure cared very much about them compared to 36% for their father figure.
Approximately 24% strongly agreed they were satisfied with their relationship with their mother figure, and about 14% strongly agreed they were satisfied with their relationship with their father figure.
Using Correct Name and Pronouns:
Youth commonly ask their trans friends (92%) and non-trans friends (84%) to call them by their correct name or pronouns.
There has been a significant increase in youth asking their friends to use their correct name or pronouns compared to 2014.
Positive Role Model:
64% of youth reported there were trans and/or non-binary people they really want to be like, and 77% reported having a trans and/or non-binary person who they admire or look up to.
Conclusions and Recommendations:
Eliminate Disparities Between Provinces:
Address inequities experienced by youth across all provinces and territories, particularly in areas such as gender-affirming healthcare, safe schools, and legal documents.
Ensure equitable coverage for gender-affirming healthcare, safe and welcoming schools, access to affirming legal documents, and protection from discrimination and violence.
Knowledgeable and Accessible Health Care Services:
Improve access to health care for trans and/or non-binary youth by ensuring healthcare workers are knowledgeable about their care.
Provide timely access to gender-affirming care and create opportunities for healthcare professionals to improve competency in providing care that meets professional standards.
Safe Washrooms and Public Spaces:
Ensure access to safe washrooms and public spaces for trans and/or non-binary youth.
Implement inclusive policies allowing access to washrooms that match gender identity to increase perceived safety and improve mental health outcomes.
Inclusive and Comprehensive Sex Education:
Provide inclusive sex education across Canada that aligns with federal guidelines and includes information specific to the needs of gender and sexual minorities.
Sex education classes should not be segregated by gender to provide equal education and resources for all students and normalize diverse experiences of sexuality and gender.
Limitations and Suggestions for Future Research:
Focus specifically on the lives and experiences of trans and/or non-binary youth who are Black, Indigenous, or from other cultural groups.
Conduct longitudinal studies to measure change over time.
Include measures of gender identity in population studies in Canada to allow trans and/or non-binary youth to be visible, and their experiences included.