Gender-affirming care is a pivotal part of the mission of McGill’s Student Wellness Hub, according to its director, Dr. Vera Romano, “but it’s also an area that’s historically been seen as a potential pain point, or gap, by our trans community.”
As a result, Romano and her staff have made ongoing efforts to partner with students, incorporate more patient voices, and establish concrete improvements to its services.
“While there have been gains there’s still a lot of fragility, and we’re working to try to stabilise these gains,” said Romano. “It’s not a case of ‘we’re doing better, so the job is done.’ Our community is telling us we need to continue to do better, and this is something we aim to be more intentional about.”
Meeting students’ needs
McGill’s Student Wellness Hub serves as a holistic access point for student health and wellness. Since its launch, it has sought to be at the forefront of best practices for its transgender and gender-diverse students.
It offers gender-affirming care options provided by family physician Dr. Hashana Perera and local wellness advisor Margot Nossal, as well as access to counsellors, nurses, sexologists and dieticians – all of whom are trained to address the needs of 2SLGBTQIA+ students.
And although the Hub does not perform gender-affirming surgeries, the staff is equipped to support individuals through the process, including by providing supporting documentation.
“We’re providing services to help them achieve their goals and lead their happiest, healthiest lives,” said Perera. “It’s a need our students have, and it’s a need they’ve had for a long time.”
“I’ve spoken to many first-year students who’ve checked out our services even before coming to the university, which is telling,” said Nossal. “It’s to the benefit of students who need this kind of care.”
Hub staff credit Dr. Pierre-Paul Tellier, McGill’s former Director of Student Health, for being a pioneer in providing gender-affirming care. He led the Student Health Service for over 30 years and went on to establish the Mauve Clinic, Quebec’s first integrated service point for LGBTQI+ migrant and racialized people; in 2022 he was shortlisted for the Collège des Médecins du Québec’s Humanism Prize.
“Dr. Perera has been very much continuing Dr. Tellier’s work, and updating it,” said Romano. “This is an area that’s changing every day.”
Obstacles and opportunities
Despite the staff’s best efforts, the Hub has encountered numerous challenges.
Prescribing gender-affirming hormones is not always adequately addressed in training for family physicians; one physician who did undergo specialized training to provide services at the Hub later moved out-of-province; and the provincial government doesn’t count time spent in university clinics towards doctors’ working requirements, making it difficult to attract staff.
Nevertheless, Romano is proud of the Hub staff’s accomplishments.
They’ve made it a priority to incorporate equity, diversity and inclusion into all facets of their services, programming and procedures; to engage in open dialogue with students, particularly with members of the Trans Patients Union; to advocate for gender-affirming training in medicine, and to ensure the Hub’s services are as visible and accessible as possible.
“Navigating services is a huge part of what I do,” said Nossal. “It’s best practice to make sure young people know about this care, and to make it as easy as possible for them to access.”
“We want to make sure every student that comes through our door is addressed by their preferred name and pronouns, regardless of whether they’re coming for gender-affirming care or because their pinky finger hurts,” said Perera. “Individuals need to be respected in a medical space.”
Providing safe space
Their efforts have not gone unnoticed. While testimonials from past and current patients cite concerns over care restrictions and frustration over the lack of providers, they also acknowledge the Hub’s improvements.
“I think there have definitely been results in terms of the Hub being more willing to engage in dialogue with us, and certain specific issues have been fixed, such as language used by doctors around referring to trans patients and their medical transition,” said one patient testimonial.
Such feedback is invaluable, particularly on the eve of the Transgender Day of Remembrance, observed annually on November 20. Seventy per cent of trans youth in Canada experience some form of sexual harassment or violence, and transgender and non-binary youth are more than twice as likely to have contemplated self-harm compared to those who are cisgender.
“I am very proud to be part of a team that provides gender-affirming care, because I know it can make a very big difference in a young person’s life,” says Nossal. “We want to be a comfortable and safe space for our students.”