Sexual health research with transfeminine persons (individuals assigned male at birth who identify as female or feminine) has focused on HIV infection and sexual function following medical treatments. Yet, approximately half of transfeminine persons in Ontario, Canada, reported no partnered sex in the previous year. Therefore, we identified sociodemographic, social, and psychosocial factors associated with past-year sexual inactivity among transfeminine Ontarians.
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Posts tagged as MTF
Disparities in Access to Family Physicians among Transgender People in Ontario, Canada
These results provide the first quantitative evidence of health disparities by race and gender within a Canadian transgender population and suggest a social gradient in access to family medicine within Ontario’s “universal health insurance” system.
(Dis) integrated Care
Barriers to Health Care Utilization for Trans Women Living With HIV
Transgender (trans) women have been particularly impacted by HIV. To seek insights into the dynamics of health service utilization, interviews were conducted with trans women living with HIV (n = 14) as part of the Trans PULSE community-based research project in Ontario, Canada.
Health Care Availability, Quality, and Unmet Need
A Comparison of Transgender and Cisgender Residents of Ontario, Canada
Evidence suggests that transgender (trans) individuals in Canada are a medically underserved population; barriers range from lack of provider knowledge on trans issues to refusal of care. This paper provides the first formal estimation of health care inequalities between trans and cisgender individuals in Ontario, Canada.
Factors Impacting Transgender Patients’ Discomfort with Their Family Physicians
A Respondent-Driven Sampling Survey
Representing approximately 0.5% of the population, transgender (trans) persons in Canada depend on family physicians for both general and transition-related care. However, physicians receive little to no training on this patient population, and trans patients are often profoundly uncomfortable and may avoid health care. This study examined factors associated with patient discomfort discussing trans health issues with a family physician in Ontario, Canada.
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Toward a Broader Conceptualization of Trans Women’s Sexual Health
Drawing on the theoretical constructs of cisnormativity and cissexism, as well as previously published and new data from Trans PULSE, a community-based study of trans health in Ontario, we discuss the social context and sexual realities of trans women’s lives. Read more
Transphobia and other Stressors Impacting Trans Parents
Limited research regarding transsexual or transgender (trans) parents has often focused on their children. This analysis represents the first published profile of trans parents (N = 110) from a large probability-based sample of trans people (N = 433). Read more
Barriers to Well-being for Aboriginal Gender-diverse People
Results from the Trans PULSE Project in Ontario, Canada
Despite health inequities experienced by Aboriginal and transgender (trans) communities, little research has explored the well-being of Aboriginal trans (gender-diverse) people. This paper aims to describe barriers to well-being in a sample of Aboriginal gender-diverse people in Ontario, Canada.
Sex and Gender Diversity Among Transgender Persons in Ontario, Canada
Results From a Respondent-Driven Sampling Survey
Recent estimates suggest that as many as 1 in 200 adults may be trans (transgender, transsexual, or transitioned). Knowledge about dimensions of sex and gender in trans populations is crucial to development of inclusive policy, practice, and research, but limited data have been available, particularly from probability samples.
Reported Emergency Department Avoidance, Use, and Experiences of Transgender Persons in Ontario, Canada
Results From a Respondent-Driven Sampling Survey
Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented.
New Trans PULSE Report on Cancer Screening
The Trans PULSE Project has produced a new report focused on perceived need for, and access to, Pap tests and mammograms for trans Ontarians. Read more
Breast and Cervical Cancer Screening Among Trans Ontarians
A report prepared for the Screening Saves Lives Program of the Canadian Cancer Society
The objective of this report is to provide requested information on perceived need for, and access to, Pap tests and mammograms for trans (transgender, transsexual and transitioned) people in Ontario, using data from the Trans PULSE Project.
Among FTM trans people who had not had hysterectomies, 56.2% reported perceived need for a Pap test in the past year, of whom 83.1% were able to access one. In other words, an estimated 46.7% of FTMs who had not undergone hysterectomies had accessed a Pap test in the past year. Ten FTMs who had not had chest surgery (mastectomy) reported perceived need for a mammogram in the past year, of whom 7 were able to access one. Among MTF trans people who were on estrogen, 12 of 16 participants who perceived need for a mammogram were able to access one. Read more
Suicidality among Trans People in Ontario/ La suicidabilité parmi les personnes trans en Ontario
Implications for social work and social justice
Abstract: While transgender and transsexual (trans) communities have been documented to experience high rates of suicidality, little attention has been paid to how this may vary based on experiences of social injustice. Using survey data from the Trans PULSE Project (n=433), we estimated that suicidal thoughts were experienced by 36% of trans Ontarians over the past year, and that 10% attempted suicide during that time. Moreover, we documented that youth and those experiencing transphobia and lack of support are at heightened risk. Suicidality varied greatly by medical transition status, with those who were planning to transition sex, but who had not yet begun, being most vulnerable. Recommendations are made for improving wellbeing in trans communities, through policy advocacy, service provision, access to transition care, and fostering accepting families and communities.
Résumé: Bien qu’on ait déjà établi que les membres des communautés transgenre et transsexuels (trans) connaissaient des taux de suicidabilité élevés, on n’a que très peu porté attention jusqu’ici à la façon dont ces taux pouvaient varier en fonction d’expériences d’injustice sociale. Read more
Nonprescribed Hormone Use and Self-Performed Surgeries
“Do-It-Yourself” Transitions in Transgender Communities in Ontario, Canada
Objectives. We examined the extent of nonprescribed hormone use and self-performed surgeries among transgender or transsexual (trans) people in Ontario, Canada.
Methods. We present original survey research from the Trans PULSE Project. A total of 433 participants were recruited from 2009 to 2010 through respondent-driven sampling. We used a case series design to characterize those currently taking nonprescribed hormones and participants who had ever self-performed sex-reassignment surgeries.
Results. An estimated 43.0% (95% confidence interval = 34.9, 51.5) of trans Ontarians were currently using hormones; of these, a quarter had ever obtained hormones from nonmedical sources (e.g., friend or relative, street or strangers, Internet pharmacy, herbals or supplements). Fourteen participants (6.4%; 95% confidence interval = 0.8, 9.0) reported currently taking nonprescribed hormones. Five indicated having performed or attempted surgical procedures on themselves (orchiectomy or mastectomy). Read more
Experiences of Transphobia among Trans Ontarians
Transphobia has been described as an “irrational fear of, aversion to, or discrimination against people whose gendered identities, appearances, or behaviours deviate from societal norms”. This includes transgender, transsexual, transitioned, transgender, and gender-queer people, as well as some two-spirit people. Transphobia exists within a context of cisnormativity, the expectation that all people are- and should be- cisgender, or non-trans. Transphobia includes acts of exclusion, discrimination, and violence, as well as attitudes that trans people may themselves internalize. Here we present information about the types and levels of transphobia experienced by trans people in Ontario.
New Trans PULSE Report on Identity Documents
The Trans PULSE project has produced a new report focused on social gender transition and the status of sex designations on goverment-issued identity documents for trans Ontarians.
Trans Ontarians’ Sex Designations on Federal and Provincial Identity Documents
A report prepared for the Canadian Human Rights Commission
The objective of this report is to provide requested information on social gender transition and the status of sex designations on government-issued identity documents for trans (transgender, transsexual and transitioned) people, using data from the Trans PULSE Project.
An estimated 48.0% of trans people who had socially transitioned to live full-time as men or women had no government-issued identification that reflected their lived gender. While a full discussion of the implications is beyond the scope of this report, this does represent a special situation in that the complete absence of identification matching one’s lived gender creates barriers to everyday activities of life.
Improving the Health of Trans Communities
Findings from the Trans PULSE Project
Trans Health Advocacy Summit Plenary. Features updated results as of August 2012.
Three New Journal Articles Published
The Trans PULSE team is pleased to share the publication of three new journal articles so far this year.
High Heterogeneity of HIV-Related Sexual Risk Among Transgender People in Ontario, Canada
A Province-Wide Respondent-Driven Sampling Survey
Background Studies of HIV-related risk in trans (transgender, transsexual, or transitioned) people have most often involved urban convenience samples of those on the male-to-female (MTF) spectrum. Studies have detected high prevalences of HIV-related risk behaviours, self-reported HIV, and HIV seropositivity.
Methods The Trans PULSE Project conducted a multi-mode survey using respondent-driven sampling to recruit 433 trans people in Ontario, Canada. Weighted estimates were calculated for HIV-related risk behaviours, HIV testing and self-reported HIV, including subgroup estimates for gender spectrum and ethno-racial groups.
Results Trans people in Ontario report a wide range of sexual behaviours with a full range of partner types. Read more
Depression in Male-to-Female Transgender Ontarians
Results from the Trans PULSE Project
High prevalences of depression have been reported in male-to-female (MTF) transgender communities. We explored factors associated with depressive symptomatology among MTF spectrum trans people in Ontario, using data from the Trans PULSE Project Phase II respondent-driven sampling survey (n=433 participants, including 191 MTFs with data needed for this analysis). We estimated the prevalence of depression at 61.2%. Factors associated with higher odds of depressive symptomatology included living outside of Toronto, having some college or university (vs. completed), being unemployed, and experiencing higher levels of transphobia. Increasing social support was associated with reduced odds of depressive symptomatology. Multivariable analyses suggested complex relationships between these factors, passing, and childhood abuse, which require additional study.
Improving the Health of Trans Communities: Findings from the Trans PULSE Project
Rainbow Health Ontario Conference Plenary
Presentation available in PDF form.
Challenging the Binary
Gender Characteristics of Trans Ontarians
Gender-related terms represent concepts that are important in how people self-identify and are rooted in social, institutional, and medical histories. Sex and gender have historically been binary—male and female—and these terms have been applied to appearance, identities, and anatomies. The assumption of two and only two categories that neatly apply to all aspects of an individual is reinforced by social, medical, religious and legal systems. A sex/gender label is generally carried throughout a person’s life and any presentation desire to change this or expand its boundaries can come at great personal costs, whether financial, emotional, or social. The information gathered by Trans PULSE challenges this binary and suggests that gender presentation and identity are more complicated with a range of diverse presentations. It also makes clear the need for further education for service providers, educators, and the rest of society.
Who are Trans People in Ontario?
Our knowledge about who trans people really are is unfortunately still very limited. Many studies have focused on only those who attend certain clinics, or seek out hormone treatment or sex reassignment surgeries.(1,2) More recent studies have tried to capture what trans people “look like” by surveying people in other venues.(3) Trans PULSE has taken a unique snapshot of trans people across Ontario – people with a range of identities, relationships with their bodies, and personal beliefs about the necessity of physical transition. The information we present was collected using a unique research method that would allow us to take the most statistically accurate picture of trans people possible in Ontario.