University of Saskatchewan study finds the key to helping trans patients access health care

Patients participating in online focus groups said they face several barriers to accessing care. Among the identified challenges are long wait times, lack of appropriate services in rural areas, insufficient knowledge among health-care workers, and even problems having their preferred names and genders recognized.

“Patients want trans-friendly services and service providers,” said Dr. Megan Clark (MD), academic family doctor in USask’s Department of Family Medicine, and co-author of the study presented to a conference of health-care workers in late November.

Based on national population estimates, Saskatchewan has between 6,000 and 10,000 people who are trans or gender diverse. Through a pilot program implemented in April 2021, and based on a program in British Columbia, two peer navigators—one based in Regina and the other in Saskatoon—have been helping connect Saskatchewan’s trans and gender diverse population with appropriate services and helping educate health-care workers.

According to interview responses from both health-care workers and those using the services, trans-friendly health-care system navigators are essential to connecting people with appropriate services. Nearly 90 per cent of clients surveyed after consulting a navigator were satisfied with the service and felt confident accessing health care; the level of satisfaction and confidence was even higher among the health-care workers.

Per the online focus groups, most clients sought information, help with changing their names or gender markers, and referrals to or help with preparing for visits with family physicians or mental health specialists. They appreciated having someone to talk to who understood what they were experiencing.

“There were just questions that I could ask [the peer health navigator] that other people wouldn’t understand,” one client told researchers. “So, there was a sense of mutuality, which is really important in the health care and advocacy stuff that I’ve gone to him about too. It’s understanding what it is to fight for our rights, and that he innately understands that.”

For health-care workers, the navigators helped to grant access to further education and connections with more experienced health-care providers. According to responses provided in the focus groups, health-care workers valued the navigators’ ability to help them connect their medical knowledge to the lived experience of being trans.

“There is value in that shared identity where it’s like, ‘OK, I don’t have to explain this to you, you’re going to explain it to me, and you have gone through it yourself, so it’s going to be maybe more compassionate, maybe less medical, maybe more holistic,’ if that makes sense,” one provider who accessed the navigators said.

Preliminary findings from the research were presented in fall 2022 at the World Professional Association for Transgender Health Conference in Montreal. The research team, which includes Dr. Alana Cattapan (PhD), an adjunct professor at USask’s Johnson Shoyama Graduate School of Public Policy and a Canada Research Chair at the University of Waterloo, will be following up this study with articles and manuscripts in future academic journals.

“People who are trans and gender diverse deserve quality health care, and the health navigators are helping people get what they need,” Cattapan said. “The work of the research team, and especially the ongoing work of the navigators, is really helping to improve quality of care, and making a real difference in people’s lives.”

Although the research project—funded by a Saskatchewan Health Research Foundation Sprout grant—has concluded, the navigator service is now being administered by Trans Sask. The navigators can be contacted through Trans Sask’s website.