Improving mental health care access for transgender people

By Patrick Callan, Communications Coordinator

 Dr. June Lam has a very personal connection to his work. 

“I lost someone to suicide who was transgender,” says the Clinical Associate and Psychiatry Fellow at CAMH’s Adult Gender Identity Clinic. “As a queer person, I just felt like I wanted to be a better ally to our transgender peers and community members.”

His master’s thesis in clinical epidemiology at the University of Toronto is looking at access to mental health care for transgender patients in Ontario after discharge from a mental health hospitalization or mental health-related emergency department visit. 

“I’m really interested in using research as a way to advocate for policy and program changes for and with transgender people,” he says. 

Dr. Alex Abramovich, Principal Investigator, Investigating Mental Health Care Utilization Trajectories and Mental Health Outcomes Among Transgender Individuals in Ontario—funded by CAMH's Discovery Fund—has already identified 2,000 transgender individuals in Ontario and linked their administrative health data via IC/ES and is providing access to the data, as well as content expertise. 

June and Alex, who is also an Independent Scientist in CAMH’s Institute for Mental Health Policy Research, recently published an article titled Transgender-inclusive care in the Canadian Medical Association Journal. The article offers health care providers tips on how to support and provide care for transgender people.

“Transgender individuals experience major challenges accessing health-care services due to erasure, stigma and discrimination, resulting in negative physical and mental health outcomes,” says Alex. “Education and training are key components to providing inclusive and affirming care to transgender patients.”

It’s also important to approach transgender patients in an inclusive way, such as asking for their correct name and pronouns, which are not always the same as the sex marker or the name on their health cards.

Another key finding is the importance of fertility preservation and making sure that before a transgender person goes on hormone therapy or looks at medical transitioning they know about their options of fertility preservation. 

And when it comes to mental health, transgender people are significantly more likely to attempt suicide. Previous research found that four per cent of the general Canadian population has attempted suicide compared to 43 per cent of transgender people in Ontario.  

“We think that disparity is not because of them being transgender, but because of the oppression they face from not being offered jobs and being discriminated against by their family and community,” says June. “Another reason why I feel so strongly about working with this population is to understand their access to care and what their needs are in order to better support them.” 

A part of the solution

June’s clinical work at the Adult Gender identity Clinic focuses on working with transgender and gender non-binary people. Through research, he’s also looking to determine if telemedicine would help increase attendance rates. If it does, the next step may be to look at ways to increase telepsychiatry appointment options at the clinic.

More broadly, he hopes there will be more research and evidence to support better mental health care for CAMH’s transgender patients.  

“I hope we will be better able to address the social determinants of mental health for transgender people,” he says. “I’d like to see the rates of mental illness and suicidality be significantly reduced compared to what they are now.”

CAMH’s Adult Gender Identity Clinic offers specialty services to both individuals and their primary care practitioners in Ontario regarding issues related to gender identity and expression, including gender expansive, trans and non-binary identities. 

The program offers a comprehensive response to the variety of clinical issues experienced by patients. The clinical team is interdisciplinary and includes social work, psychiatry and psychology staff with specialized expertise in trauma-informed mental illness and addiction care.

For more information on CAMH’s Adult Gender Identity Clinic please click here.