The issue

Transgender and non-binary people face barriers to health care and well-being

“Whether it’s negative experiences with health care providers, sexual and reproductive health issues, or a high risk of harassment, transgender and non-binary people face a number of challenges when it comes to health equity,” says McMaster professor Randy Jackson, a social work professor and member of the Trans PULSE research team.

Jackson, an Anishinaabe from Kettle and Stony Point First Nation, is a leading researcher on HIV in Indigenous peoples in Canada. “Indigenous trans individuals encounter double discrimination from racism and transphobia,” he says. “Their health, safety and quality of life requires urgent attention.”

Not satisfied with research that pathologizes this population, Jackson has always taken a community-first approach. “I work directly with communities, talking to them and allowing them to shape the research,” he says.

The research

A census exploring the trans and non-binary population’s experiences

Do trans and non-binary people across Canada have equal access to health care? How is their general health compared to the rest of the population? What unique threats decrease their well-being? Answers to these questions are vital for equitable policymaking, but until now they were largely unavailable.

Jackson is part of the majority-trans group of community and academic researchers who are involved in Trans PULSE Canada, the first national, all-ages, community-based survey of the health and well-being of trans, non-binary and Two-Spirit people. As a member of the survey’s Indigenous Leadership Group, he’s planning a follow-up study using Indigenous and decolonizing methodologies.

The research team brings more than 180 years of experience on more than 80 community-based research studies. The team’s recent work builds on Trans PULSE (Ontario), a study that collected data –via focus groups, surveys, and interviews – from trans people in Ontario.

Outcomes & impact

Community engagement key to survey success

The Trans PULSE survey data from more than 2,800 trans and non-binary people is unequivocal: this group is not on an equal footing with other Canadians when it comes to their health and well-being.

Almost half of the respondents said they have at least one unmet healthcare need, and 56 per cent rated their mental health as fair or poor. They reported high rates of violence and harassment, and one in three said they’d considered suicide in the past year. This nation-wide data on the rife inequities in the trans and non-binary population can now inform policy changes in areas ranging from primary and emergency healthcare to policing and sex work. “The evidence is stark, and it’s time to act,” says Jackson.

Lessons learned & Shared

Fresh evidence that trans and non-binary people have unmet healthcare needs

“To understand the obstacles to equality encountered by any community, especially a marginalized one, we must work in partnership with its members,” says Jackson. “The Trans PULSE survey questions were designed by and for the people we worked with.”

The researchers also made it as easy as possible for respondents to complete the survey. There was a short and long form in multiple languages, and different formats were available for accessibility.