One of the only clinics offering gender-affirming medical care in Thunder Bay, Ontario, has closed, leaving few options for trans patients in the city and surrounding region.
Last week, the Umbrella Medical Clinic, who provided sexual health servicesannounced its closure until further notice.
“It feels like whiplash,” patient Dax O’Neill said of the Umbrella Clinic’s closure. “It’s going to be difficult for me to get testosterone, the treatment I need.”
Gender-affirming care is a broad term for health care that supports a patient’s gender identity and expression. This can include any combination of counseling, hormone therapy, puberty blockers, and surgeries.
Umbrella Medical Clinic opened in 2018 with the goal of filling gaps in Thunder Bay’s health system by offering everything from transgender health care to emergency contraception and HIV prevention. It closed temporarily in October 2021 after the unexpected death of founder Dr. Annabella Zawada, but reopened in August 2022.
O’Neill has not received any information about Umbrella Medical’s reopening or referrals to other practitioners.
The Umbrella Medical administrator declined an interview with CBC News, but said in an email that he had to check his website for updates.
The hormone testosterone is used by many transitioning patients to reduce estrogen production and induce “masculine” physical traits. Since it is a federally controlled substance, many walk-in clinics will not prescribe it, and O’Neill said he depends on specialists or family doctors for refills.
O’Neill added that he wanted Umbrella Clinic to say whether the closure was permanent or provide more information.
“They didn’t list any resources that we could go to or even try to connect us with anything. It was just like, ‘Fight for yourself,'” O’Neill said. “I feel like I’m abandoned.”
NorWest Community Health Centers in Thunder Bay also offer “gender-affirming shared care,” according to their website.
But Sarah Martin, another Umbrella Medical patient, also had to struggle to find resources.
Not being able to access this care could be a matter of life and death.– Dr. François Doiron
“I’m pretty upset. I kind of felt like I was part of the Umbrella herd,” she said. “I know the people there really cared about all of us.”
Martin, who has been on hormone replacement therapy (HRT) for more than two years, said all she needs to do is refill her prescriptions and have annual checkups to monitor any side effects that may arise. But Martin said she worries it will be difficult to find a provider comfortable enough to manage her HRT in Thunder Bay.
Dr. François Doiron, a family physician in Dryden who provides gender-affirming care to patients in the area, said Martin’s fears are justified and that this care is essential for them.
“Not being able to access this care could be a matter of life and death,” Doiron said.
“This population is at very high risk for depression and mental health problems,” he said. Suddenly stopping certain types of gender-affirming care, such as hormone therapy, can have significant negative impacts on physical health. »
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O’Neill and Martin said their family doctors have already expressed discomfort with providing gender-affirming care.
Few doctors in Ontario offer such services. It’s difficult to find a supplier, even in big cities like Toronto, and it’s even harder in northwestern Ontario, Doiron said.
“It’s even more than difficult,” he said. “Sometimes it’s almost impossible.”
A 2019 Trans Pulse Canada survey of transgender and non-binary people aged 14 and older across Canada found Nearly 45 percent reported having unmet health care needs. Among survey respondents who were continuing gender-affirming care, 40 percent said they were on waiting lists, most often for surgery.
Both O’Neill and Martin said they want to see more practitioners in Thunder Bay offering gender-affirming care.
“I hope our GPs and family doctors can get more involved in this as it becomes more and more prevalent in society,” Martin said. “Our care is really not that difficult to manage.”
O’Neill wants another clinic to open in Thunder Bay with community support.