“45% [of respondents in Ontario] reported having one or more unmet healthcare needs in the past year.” because they were trans or non-binary, 12% had avoided going to the emergency room in the past year, despite needing care.”
(Trans PULSE Canada team, 2020).
INTRODUCTION
ACT has been in the process of organizing an engagement committee since 2021, centering trans and nonbinary folks from all walks of life to inform and direct the development of the Empower Trans Folks campaign. Empower Trans Folks is a collection of digital sexual health and self-advocacy skill development resources designed to:
- Improve health literacy of transgender and nonbinary bodies,
- Improve capacity to self-advocate for competent and affirming care,
- Reduce the impact of transphobic microaggressions, and
- Improve holistic health and well-being.
The Trans Health Card was created as a community-informed and researched response to the underserved frequency and severity of transphobic barriers and microaggressions in medical settings, including deadnaming, misgendering, and identity erasure.
This resource encourages folks to proactively communicate gender-related health information with their healthcare provider. In doing so, we anticipate folks will gain an increased sense of control, autonomy, and safety when accessing healthcare and reduce the number of trans and non-binary folks with unmet healthcare needs.
We have an English version and a French version, translated by one of our partners, REZO!
TRANS HEALTH CARD INSTRUCTION MANUAL
MY NAME IS: The top space is preserved for the name of the person receiving care. This is an open invitation to address them by this name, not by any other name.
PLEASE DO NOT USE THIS NAME: If the person chooses to disclose their deadname or legal name in this section, this does not permit you to use it outside the official documentation. This section is included only to help medical staff members link the patient’s Trans Health Card to their government documentation. Using it outside of this context, i.e. using their dead name rather than the name they’ve given you above, will only further extend the transphobic microaggressions that trans and nonbinary patients experience.
MY PRONOUNS ARE: These are the pronouns that the client uses in their life. There are many variations that people may use.
If you find yourself struggling to use the person’s pronouns, please utilize this pronoun tool created to help explain the use of pronouns other than he, she, and they.
GENDER IDENTITY: This invites the client to share their gender identity with you.
If you are unsure of the terms used within this box, please use the resources below to find out more about specific gender identities. There is no expectation to be experts in the expansive world of gender identities. However, it’s important to show care, interest, and dedication toward supporting your trans and nonbinary clients better.
GENDER ASSIGNED AT BIRTH: Referred to as ‘Sex assigned at birth’ in most medical spaces.
If the client shares this identity marker with you, it does not dictate their gender identity or pronouns. It would be more proactive to ask about the specific body parts relevant to the appointment.
(I.E., An intersex, genderfluid client comes in for a medical appointment for sexual health and/or cancer screen involving their genitals. Asking the client if they would require a pap smear and/or prostate exam would invite the client to disclose their body’s makeup rather than medical staff making assumptions.)
NAME OF HRT (HORMONE REPLACEMENT THERAPY): Also known as “gender-affirming hormone therapy,” this section will include the medication name and type, including the brand, of the hormone therapy that the person is taking.
This section also includes their dosage amount, how often they take their treatment, and when they started.
LAPSE IN TREATMENT: This section acknowledges that there may have been a lapse in continuous/ongoing treatment as there may be additional symptoms to look for. Please include the date of the most recent lapse in HRT. This is not about why there was a lapse, but so that medical staff can be aware of any effect that might appear because of the break in treatment.
**I.E., If someone has a lapse in estrogen, they could get hot flashes, headaches, fatigue, and mood swings. Meanwhile, a person who has a lapse in testosterone could become lethargic and have mood instability.
For more information, please read this article by Alex Nguyen called “A death sentence”: Trans Texas teen plots his future as the proposed ban on hormone therapy progresses. It speaks on the experiences of trans and nonbinary folks in Texas when they were no longer allowed access to HRT.
If they choose to share this information, it is essential to acknowledge there are a variety of reasons why clients may not have been taking their hormones. I.E. Hormone shortages, low-income, unable to access an affirming health care provider, etc.
GENDER-AFFIRMING SURGERIES: This section allows clients to disclose any gender-affirming surgeries or procedures they have had, including the date received. If you’d like more information about the types of surgeries and what is involved, please use this guide created by Madeline B. Deutsch called “Overview of gender-affirming treatments and procedures” to help inform you more about this topic.
ACCESSIBILITY NEEDS: This section is for clients to share their accessibility needs. This can include both physical as well as mental accessibility needs.
I.E., Clients who cannot climb stairs, clients who are sensitive to loud noises or bright lights, etc.
ADDITIONAL THINGS TO KNOW: This allows clients to share any additional information that would help make their visit accessible and inviting.
TRAINING
In-depth training on the Trans Health Card can be provided. Please contact our Queer Community Health Systems Coordinator:
Kenny Dawkins (pronouns: they/xe)
kdawkins@actoronto.org
416-340-8484 ext. 242
REFERENCES, RESEARCH, & RESOURCES
Findings and recommendations from ACT’s community consultation for trans men and trans masculine folks (Mike Smith & Andy Lessard 2020)
Report – Health and health care access for trans and non-binary people in Canada (Trans Pulse Canada, 2020)
Report – Health and well-being among non-binary people (Trans Pulse Canada, 2021)
A Guide to Gender Identity Terms (Laurel Wamsley)
72 Gender List (72Gender.com) Comprehensive list of most genders identifies.
Pronoun Game (Minus)
A death sentence: Trans Texas teen plots his future as the proposed ban on hormone therapy progresses. (Alex Nguyen, 2023)
Overview of gender-affirming treatments and procedures (Madeline B. Deutsch, MD, MPH, 2016)