Program will look at improving trans, gender-diverse health care in N.B.

From prescribing hormones to referrals for voice therapy, general practitioners in New Brunswick will be able to receive trans and gender-diverse health-care training under a federally funded program. 

Called Building Capacity for Sustainable Trans Health Care in N.B., the 25-month program is funded through Women and Gender Equality Canada and facilitated through Fredericton-based LGBTQ+ advocacy group Imprint Youth Association. 

It will develop training for New Brunswick primary care providers on how to offer health-care services to trans and gender-diverse patients.

Reid Lodge, one of the people who originally submitted a grant application for the program before the COVID-19 pandemic, said doctors might not receive trans health-care training in medical school, or they might not be comfortable providing it. 

"It's not that they don't want to work with trans people, but they don't really feel that they have the knowledge to work with that population," they said.

In other provinces, Lodge said there are whole institutes set up with training programs and practitioners who have this kind of education.

Since Clinic 554, a family practice in Fredericton that offered transgender and gender-diverse health-care services, closed in 2020, there hasn't been a central location to access those services. 

Lodge had been a patient at the clinic, along with many of their friends. 

"Now that the clinic is closed, a lot of them are without practitioners, and it's really a struggle to find practitioners that are willing to do the kind of prescriptions or referrals that they need, so it'll definitely be a relief to have this available."

One of the program's goals will be to make the training material permanent, so it lasts beyond the project's timeline. Lodge said another goal is to expand it across the entire province. 

The training will also help practitioners understand that every medical transition journey is unique to the person undergoing it, Lodge said.

"We want to make sure they know that transition is unique and there's not just hormones and surgery. There's a whole realm of options people can look at."

The federal government initially denied the program's application. About two months ago, Lodge said the government approached them and said after rereading the application, it had decided to grant the funding.

Lodge said this created an opportunity to rewrite the application and receive funding approval to also work with Indigenous communities, as well as pay for Indigenous language translation of the training materials once they're complete.

"We'll definitely be reaching out to elders and members of the two-spirit community to make sure the training materials are available to as many major populations in New Brunswick as possible," Lodge said.

Nicki Lyons-Macfarlane, a board member with the Imprint Youth Association, said primary care providers uncomfortable with prescribing hormones often refer patients to endocrinologists, doctors who specialize in hormone-related diseases and conditions.

The wait to see an endocrinologist can be two or three years, according to Lyons-Macfarlane.

"Our hope is that through this mentorship training program, primary care providers can easily help their patients navigate the system and prescribe hormones instead of sending them to another wait list," they said.

The online response to the program announcement was enthusiastic, Lyons-Macfarlane said. 

"There's a lot of people saying it was about time this was happening, there's a lot of relief and excitement."

But there was also hesitation, according to Lyons-Macfarlane, who said some community members felt burnout from trying to navigate the system in New Brunswick and didn't want to get their hopes up.

"The process is very long and confusing. So alongside enthusiasm, there was a little bit of hesitation, because this province is really, really behind," they said.

But Lyons-Macfarlane is hopeful primary care providers will participate in the program. The project team will be reaching out to them starting in April, and the first cohort will take about a year to train, Lyons-Macfarlane said.