Sexual health clinics provide essential services, but these spaces can sometimes present accessibility challenges to trans and gender variant people. There are many things that can impact how trans and gender diverse clients experience clinic spaces.
Trans and gender diverse clients may experience significant discomfort, humiliation or trauma when interfacing with a system that doesn’t consider their bodies and needs. Fortunately, much can be done to make clinic spaces safer and accessible to people of all genders.
In this three-part series, we will explore a number of ways in which the entire clinical experience can be improved for trans and gender variant clients.
In Part 1, we will consider the barriers faced by trans clients when accessing clinical services and how clinic spaces can physically be made more welcoming. In Part 2, we will look at how clinical systems and procedures can be modified to create a more inclusive space. In Part 3, we will examine how accessibility may be improved for trans clients that face additional accessibility barriers.
PART 1 – Barriers faced by trans and gender variant clients
Trans and gender variant people may encounter a number of significant barriers when trying to access clinical services, including:
- May have a different gender than listed on their Care Card.
- May have a different name than listed on their Care Card.
- May be read as the wrong gender by other people, including front line staff.
- May have a gender identity that is not widely known or understood. They may not identify at all with a binary male/female gender. Some examples of non-binary gender identities include genderqueer, nongender and gender fluid.
- May not be ‘out’ as trans, and may experience repercussions if outed in the waiting room or another public space.
- May face regular discrimination navigating medical systems and public spaces, and be understandably cautious or fearful of accessing these places.
- May have avoided accessing medical spaces for years, even decades, or may never have accessed sexual health services before.
- May have intersectional accessibility needs, such as being trans and using a wheelchair.
Creating better spaces
The physical spaces that clinicians work in, as well as the procedures and systems they use, can have a huge impact on client experiences.
Creating a welcoming physical space, updating operational procedures and investing in comprehensive staff education all play a part in reducing barriers for all clients who have been historically marginalized by health systems.
Posters, signs and images of trans and gender diverse people are scarce in public spaces. Adding trans-friendly posters and signage to clinic spaces increases recognition and visibility of trans people, and can help create a more welcoming and inclusive environment.
Some organizations have created posters that are available for distribution.
- Our City of Colours: 16 multilingual posters in Chinese, Punjabi, Farsi, Spanish, Russian, French, Filipino, and Vietnamese to increase visibility for LGBTQ people in diverse linguistic and cultural communities.
- Prism: Vancouver Coastal Health’s clinical, education, information and referral service for lesbian, gay, bisexual, trans, queer and Two Spirit (LGBTQ2S) communities.
Prism Services Poster 1
Prism Services Poster 2
- Rainbow Health Ontario: Positive space posters and stickers.
- Ontario Counsel of Agencies Serving Immigrants: Free, downloadable Positive Spaces multi-language kits.
Gendered washrooms can present a major barrier to trans clients. In one study, 57% of trans people reported avoiding using washrooms due to fear of harassment.
Non-gendered washrooms are one way to reduce the stress of accessing washrooms. Converting gendered washrooms to non-gendered can be as simple as a new sign on a washroom door saying “all genders welcome,” or an icon indicating toilets and/or urinals.
If gendered washrooms can’t be converted into non-gendered washrooms, consider adding a “trans people welcome” sign on all washrooms.
For shared spaces where building managers are not accommodating of permanent changes, create temporary signs that can be taped over washroom doors during the time the clinic is in use.
Next up in this series: Part 2 – Systems and Procedures
- Scheim A, Bauer G, Pyne J. Avoidance of Public Spaces by Trans Ontarians: The Impact of Transphobia on Daily Life. Trans PULSE e-Bulletin, 16 January, 2014. 4(1)