Making primary care for transgender patients a priority

By Madison Thakore

Sasha, 36, has identified as a woman for as long as she can remember.

“My transition started when I was really young,” says Sasha. “I self-identified as female and knew that was correct when I was five or six.”

Growing up in rural Nova Scotia, finding a health-care provider who could help with her transition proved challenging. It took until Sasha was 17 to find a doctor able to begin her medical transition, involving hour-long drives between her small town and Halifax.

Upon moving to Toronto, Sasha found the St. Michael’s Hospital Academic Family Health Team at the Health Centre at 410 Sherbourne. She has now been a patient under the care of Dr. Thea Weisdorf and primary health care nurse practitioner Sue Hranilovic for seven years.

Transgender patients each view transition in their own way. It may be expressed socially, medically, through a gender confirming surgery or any potential combination. Dr. Weisdorf and Hranilovic work with each patient to define their own individual journey. ¬¬

“What I really liked about Dr. Weisdorf is that I didn’t feel like I had to prove myself to her,” says Sasha. “She said to me, ‘I see you, I believe you.’”

Finding a trans-affirming medical provider is not always simple. Yet, research shows that when there is comfort and trust in a primary care provider, patients are more likely to visit and there is improved physical and mental health. The six St. Michael’s Hospital Academic Family Health Team sites provide priority care to over 400 transgender and gender non-binary individuals across Toronto, not just in our catchment areas.

Care provided to any patient is about more than surgery preparation or prescriptions. It is about developing a support system that extends beyond medical requirements.

Did you know? In March 2016, provincial legislation was approved allowing qualified primary care providers to offer transition-related surgery referrals for patients. Prior to this, the Centre for Addiction and Mental Health was the only qualified institution able to provide references. In the past two years, 102 referrals have been made by the St. Michael’s Hospital Academic Family Health Teams.

For health-care providers such as Dr. Weisdorf and Hranilovic, creating a safe space where patients are able to address all of their spiritual, emotional and physical health needs is critical to each individual journey.

“I felt that she was an incredible wealth of knowledge and really approachable. You felt like you could really talk about anything with her,” says Sasha of Hranilovic.

The support system also extends to patients’ families. No matter a patient’s age, parental support contributes to a more positive transition.

Even at a time and place where transgender knowledge may have been limited, the encouragement and support from Sasha’s own family had a significant impact.

“They were very supportive,” says Sasha of her grandparents, who raised her. “They were very emotionally supportive – knowledge-wise they may not have known anything and they didn’t necessarily know where to take me… but socially, because I had that support in my life I was able to make that transition a lot earlier.”

Sasha remains a patient of Dr. Weisdorf and Hranilovic.

“They’re not just wonderful professionals, but just wonderful people who are very open and accepting.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.