03/06/2019 15:55 EST | Updated 03/06/2019 16:44 EST

More Demand For Transgender Youth Health Care Shows It's Needed: Expert

There aren't enough Canadian doctors who work on gender to serve the community's needs.

Zinkevych via Getty Images
Gesturing while talking. Scaled up shot of a therapeutic process between a professional therapist and a teenage boy in an office.

More Canadian teens are seeking treatment because they don't identify with the gender they're assigned at birth — and it's happening so quickly that our health-care system can barely keep up.

But Dr. Greta Bauer of Western University told HuffPost Canada she wants to stress that the increase doesn't necessarily mean there are now more transgender kids. What it does mean is more people who realize they're trans as children or teens are getting treatment they need at an earlier age.

"This is a very, very good thing and nothing to be alarmed about," said Bauer, the principal investigator for the ongoing Trans Youth Can project, which studies the medical, social and family experiences of trans youth in Canada.

What is a gender clinic?

Gender clinics for youth, which generally accept new patients only by doctor referrals, provide several different services. Not all of them see young children, and the ones that do offer counselling services, but no medical procedures. When kids are closer to puberty, they can receive blockers that will delay their puberty by blocking the onset of either estrogen or testosterone. Once they're teens, they can receive gender-affirming hormones, which will help their bodies adapt to the gender that matches their identity.

When the gender clinic at Toronto's Sick Kids hospital opened in 2013, they received 100 referrals in the first year, a spokesperson told HuffPost Canada. Now they see 200 a year. B.C. Children's Hospital's gender clinic, which opened in 1998, has also seen major growth in the last few years — they saw about 20 children and teens in 2013, hospital spokesperson Leslie Dickson said, a number that's risen to 240 in 2018.

"The increase in referrals in recent years is consistent with the trend seen in pediatric gender clinics across North America and Europe," Dickson said in an email.

Benefits of youth care

There's been a lot of public discussion about how early people understand they're trans, and how early medical intervention should happen. Several recent studies have found that even very young children usually understand their gender identity, whether it's the gender they were given at birth or not.

Bauer points to the Trans Pulse Project, an Ontario-based study she also worked on, which found that 80 per cent of transgender people said they knew they were trans by age 14.

"So many trans people will say that they wish they transitioned at a younger age, even those who transitioned at fairly young ages," she said.

Trans Youth Can
Trans Youth Can has been monitoring the number of trans and non-binary Canadian youth who are referred to gender clinics.

The change in public knowledge and perception around transgender identity has started to make it easier for trans youth to seek treatment, which accounts for the spike. "But that doesn't mean there weren't the same number of trans kids earlier who needed to access" that kind of care," Bauer adds.

"If you think about what we know about trans adults, the current estimate is 0.6 to 0.7 per cent of adults are trans," she said. "Where do all the trans adults come from, if there are no trans children?"

Still many barriers to health care

The demand for trans youth health care is so high that there aren't enough Canadian doctors who work on gender to serve the community's needs. There are more clinics than there used to be, but the number is still relatively small, and they're almost all located in big cities. And now, most have long waiting lists.

"Getting into care can take a year, sometimes two years," Bauer said. "And that's a thousand years in adolescent years."

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She added that even those much-higher numbers are a relatively small percentage of the actual population of trans kids. The children and teens who work with Bauer's team on the research project, by definition, generally have parents who are very supportive — parents who didn't support their child's gender transition likely wouldn't bring them to a clinic that would help them with that transition.

Previous studies have shown that parental support is a key factor in health and wellbeing for trans people of all ages.

Bauer said the Trans Youth Can study looks at sources of joy in the lives of trans youth, as well as the difficulties they face. Often, when we talk about what it's like to be a transgender child, we "focus on the distress, on suicidality and depression," she said. "Those things are real, but at the same time, there's some real positive experiences going on for youth. If they're starting to feel confident in themselves, feel gender-aligned, they feel hope going towards the future."

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