Gender Identity and Gender Expression
- Darlene Edgar
OHRC. Ontario Human Rights Commission. (2014). Policy on preventing discrimination because of gender identity and gender expression. http://www.ohrc.on.ca/sites/default/files/Policy%20on%20preventing%20discrimination%20because%20of%20gender%20identity%20and%20gender%20expression.pdf
Introduction:
Transgender individuals represent diverse demographics and contribute to communities across Ontario and globally.
Despite this, they face pervasive discrimination, prejudice, harassment, and violence, especially during the transitioning process.
Discrimination against transgender individuals impacts their daily lives, health, and well-being significantly.
The Trans PULSE Project's 2010 survey in Ontario revealed barriers in employment and healthcare access, with many transgender individuals living below the poverty line.
Discrimination based on gender identity and expression violates human dignity, recognized by courts and tribunals as substantial and disturbing.
Transgender individuals often avoid public spaces due to fear of harassment, leading to significant mental health challenges and a high prevalence of suicidal thoughts and attempts.
Despite challenges, there's growing recognition globally and legally of the importance of respecting gender identity and expression.
Ontario's Human Rights Code was amended in 2012 to include gender identity and expression as prohibited grounds of discrimination, providing legal protections for transgender individuals.
About this policy:
This policy updates the Ontario Human Rights Commission's original Policy on discrimination and harassment based on gender identity (2000).
It aims to promote the dignity and worth of transgender individuals, ensure equal rights and opportunities without discrimination or harassment, and foster understanding and mutual respect.
The policy helps organizations understand and meet their legal obligations under the Code to prevent and address discrimination based on gender identity and expression.
It's based on research, tribunal and court cases, and consultations with transgender individuals and organizations.
Gender identity and gender expression:
The Code doesn't define these terms but their understanding evolves from legal decisions, social science research, and common usage.
Gender identity is an individual's internal sense of gender, which may differ from their birth-assigned sex.
Gender expression is how a person publicly presents their gender, including behavior, appearance, and chosen name/pronoun.
Transgender is an umbrella term for individuals with diverse gender identities and expressions.
Gender non-conforming individuals don't adhere to stereotypical gender norms.
Lived gender identity refers to the gender a person feels internally and expresses publicly in daily life.
Bias and prejudice:
Transgender individuals face stigma, prejudice, and bias due to societal stereotypes and fears.
Stereotyping leads to discrimination based on misconceptions and incomplete information.
Transphobia, aversion or hatred towards trans people, leads to discrimination, harassment, and violence.
Cisnormativity assumes everyone is cisgender, perpetuating discrimination against transgender individuals.
5. Emerging human rights protections:
Ontario's Human Rights Code protects transgender individuals from discrimination in various social areas.
Other Canadian jurisdictions and international human rights standards also recognize and protect gender identity and expression.
Ontario’s Human Rights Code:
The Code protects transgender individuals from discrimination and harassment in areas like goods/services, housing, employment, contracts, and vocational associations.
Discrimination is established when a protected characteristic like gender identity or expression is a factor in adverse treatment.
Transgender individuals have the right to self-identify their gender, and organizations must respect their lived gender identity.
Forms of Discrimination:
Discrimination can occur in various forms, including direct, indirect, and subtle discrimination.
Direct discrimination involves exclusion, withholding benefits, or imposing extra burdens without legitimate reasons.
Indirect discrimination occurs through another person or organization, such as instructing a temp agency not to send trans workers.
Subtle discrimination, though less overt, is equally harmful and may be detected by examining patterns of behavior.
Intersecting Grounds:
Discrimination can intersect with multiple Code grounds, leading to unique forms of discrimination.
Trans individuals may experience discrimination based on race, family status, sex, or disability, impacting access to housing, employment, or services.
Stereotypes around intersecting identities contribute to disadvantage.
Association:
Discrimination may target individuals due to their association with trans or gender non-conforming individuals, such as experiencing harassment because of a roommate's identity.
Gender-based Harassment and Sexual Harassment:
Harassment, including gender-based and sexual harassment, is prohibited under the Code.
Trans and gender non-conforming individuals may experience harassment based on their gender identity, expression, or sex.
Examples of harassment include derogatory language, refusal to use correct pronouns, spreading rumors, and unwelcome touching or violence.
Poisoned Environment:
A single severe incident or ongoing unwelcome behavior can create a poisoned environment, constituting discrimination.
Organizations have a duty to maintain environments free from discrimination and to address and eliminate poisoned environments.
Systemic Discrimination:
Discrimination can be systemic, embedded in policies, practices, or culture, leading to disadvantage.
It may overlap with overt and adverse effect discrimination, compounding issues.
Organizations must proactively prevent systemic discrimination by inclusive policy design and regular review to remove barriers.
Accomodation:
Responsibilities of the Person Seeking Accommodation:
Notify the accommodation provider (employer, landlord, service provider, etc.) when Code-related needs requiring accommodation arise.
Provide relevant information about their needs and adhere to agreed-upon standards once accommodation is provided.
Cooperate to the best of their ability throughout the accommodation process.
Responsibilities of Accommodation Providers:
Accept requests for accommodation in good faith, unless evidence suggests otherwise.
Request only necessary information to clarify the nature and extent of accommodation needed.
Ensure confidentiality of information related to accommodation and share it only with relevant parties.
Act promptly and actively seek solutions.
Cover appropriate costs related to accommodation.
The principle of keeping information about someone's trans identity confidential is emphasized due to the stigma and stereotypes often faced by trans individuals.
Regarding reasonable bona fide requirements, the Code prohibits discrimination resulting from seemingly neutral requirements that have a negative effect on individuals identified by Code grounds. However, organizations may justify such requirements if they demonstrate that accommodating the person would cause undue hardship. The legal test involves proving that the requirement:
Is rationally connected to the function being performed.
Was adopted in good faith with the belief that it is necessary to fulfill its purpose or goal.
Is reasonably necessary to accomplish its purpose or goal, to the point where accommodation without undue hardship is impossible.
An organization failing to participate in the accommodation process may have met its duty if the person requesting accommodation did not sufficiently participate, refused, or could not participate due to disability or other Code-related factors. However, organizations should consider adjustments if the accommodation is ineffective.
Competing rights situations may arise when accommodation requests affect the rights of others. Organizations must address these situations, considering legislative exemptions and the significance of the interference with others' rights.
Undue hardship in accommodating trans individuals involves assessing cost, outside sources of funding, and health and safety requirements. Organizations must provide objective evidence to prove undue hardship, considering factors such as the size of operation, recoverability of costs, and mitigation of risks. They should also explore options like phasing in costs or utilizing reserve funds.
11. Complaints and reprisal:
Transgender and gender non-conforming individuals experiencing discrimination or harassment should raise the issue with relevant authorities like employers, unions, landlords, or service providers.
If the problem persists or isn't addressed, they can seek advice from the Human Rights Legal Support Centre or file a complaint with the Human Rights Tribunal of Ontario within one year of the last incident.
The Code protects against reprisal or retaliation for claiming rights under it, even if no formal complaint has been made.
People associated with those experiencing discrimination are also protected from reprisal.
12. Corporate liability:
Organizations have a legal obligation to maintain a discrimination-free environment, facing penalties if they fail to prevent or respond to Code violations.
They must address underlying issues like systemic barriers or organizational cultures condoning discrimination.
Vicarious liability holds organizations responsible for discriminatory acts or omissions by employees or agents.
Tribunals and courts may find organizations liable for failing to respond appropriately to discrimination or harassment.
13. Preventing and responding to discrimination:
Organizations should develop and implement barrier prevention plans, anti-harassment policies, accommodation procedures, and internal complaints systems.
Education and training programs should address stereotypes and discrimination faced by trans people.
Consideration should be given to specific needs during transitioning, including identity documents, washrooms, privacy, etc.
13.2 Transitioning:
Transitioning refers to the process individuals undertake to live their felt gender identity.
Accommodation may be needed during transition, such as access to private facilities or time off for medical procedures.
13.3 Identity documents:
Discrepancies on official documents can create barriers and risks for trans individuals.
International standards and case law confirm that surgery is not a requirement to change gender designation on identity documents.
Criteria for changing name or gender should be respectful and non-intrusive.
13.4 Washrooms and change rooms:
Trans individuals have the right to access facilities based on their lived gender identity.
Organizations should accommodate without undue hardship, ensuring inclusive design and accessibility.
13.5 Dress codes:
Dress codes must accommodate individuals' expressed gender, allowing for flexibility and inclusivity.
Policies should not be based solely on gender stereotypes.
Shelter Services: Transgender individuals often face discrimination and barriers when accessing shelter services. This includes feeling unsafe in gender-segregated shelters and being subjected to invasive questions about their transition status. Shelters should accommodate individuals based on their lived gender identity and provide education to staff and clients on transgender-related issues.
Healthcare Services: Transgender individuals encounter obstacles in accessing healthcare services, with many reporting a lack of understanding and respect for their gender identity from healthcare providers. Policies and procedures should be developed to prevent discrimination and ensure access to appropriate care.
Education System: Transgender youth experience prejudice and discrimination in educational settings, including harassment and lack of support from teachers and peers. Educational institutions have a responsibility to create inclusive environments and accommodate the needs of transgender students.
Law Enforcement and Justice Services: Transgender individuals are particularly vulnerable in encounters with law enforcement and correctional institutions. Policies should be developed to address discrimination, harassment, and violence faced by transgender people in these settings.
Other Services: Transgender individuals are protected from discrimination in various other areas, including retail stores and other service providers. Businesses have a duty to accommodate the needs of transgender customers.
Housing (13.11):
Trans individuals may face discrimination from landlords when seeking housing or exercising their rights as tenants.
The Ontario Human Rights Code ensures equal treatment in housing without discrimination based on gender identity or expression.
Landlords must not deny housing or discriminate against tenants based on gender identity or expression.
Landlords must address discrimination or harassment within the housing environment.
Employment (13.12):
Trans individuals report facing discriminatory treatment in employment, including being turned down for jobs or fired because of their trans identity.
Discrimination in employment includes unfounded stereotypes or negative assumptions about trans individuals.
The Ontario Human Rights Code guarantees equal treatment in employment without discrimination based on gender identity or expression.
Employers must ensure that overt and subtle discrimination against trans individuals does not occur during hiring or employment.
Trans employees transitioning publicly may face discrimination, such as being fired or demoted instead of being accommodated.
Vocational Associations (13.13):
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.