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Transforming clinical knowledge and practices to better serve trans and gender diverse populations in British Columbia: sexuality and sexual health

In British Columbia, trans* and gender diverse** folks face multiple barriers when accessing health care, especially related to sexuality and sexual health. There remains a pervasive lack of understanding and knowledge on transgender lives and bodies in Canadian health services and policy. (1)  As a result, transphobia and lack of sensitivity and familiarity with trans health care needs are entrenched in the health system. 

The Catherine White Holman Wellness Centre (CWHWC) is a unique, multidisciplinary clinic in Vancouver that arose in response to these barriers.  The centre serves as a valuable model for clinics and providers across the province when aiming to deliver care sensitive to the needs of trans and gender diverse individuals.  All services at the CWHWC are oriented toward celebrating clients’ identities and self-expression and this translates directly into the provision of sexual health care.

Staff and clinicians either identify as trans and/or gender diverse, or serve as strong allies. Clinicians are well-informed of the health needs and practical information around sexuality that is inclusive of trans and gender diverse bodies and experiences, including common concerns that folks on hormone therapy or recovering from surgery may experience.  Clinicans also provide information on a range of supports and services for enhancing sexual expression.

Clinicians are sensitive to, and acknowledge that many individuals may have experienced discrimination accessing health services in the past. At CWHWC, clients have the option to learn how to self-screen for sexually transmitted infections if they prefer to defer a physical exam. Clinicians also provide cervical screening to clients of all genders, use preferred terminologies for genitals, and practice consent during every step of the visit.

While small for now, CWHWC plans to start providing guidance, workshops and resources for other service providers so that they may inform their own understanding and care provision to trans and gender diverse people, including sexual health and sexuality.  Keep an eye on the new Tumblr blog, Sexual Health for All Genders, as well as the CWHWC website and resource page for new developments and contact information. 

If you have questions regarding the provision of quality transgender care, feel free to contact Dr. Marria Townsend.  Marria is the Physician Lead of Transgender Primary Care at Vancouver Coastal Health. Email: marriato (at) mail.ubc.ca

Another available service for provider support is Project Health’s ‘TransLine’, “a national online transgender medical consultation service that offers health care providers up-to-date transgender clinical information and individualized case consultation across a broad range of clinical transgender issues”.  While the service is American, they are able to answer basic questions about trans health provision.


(1) Bauer GR, Hammond R, Travers R, Kaay M, Hohenadel KM, Boyce M.  “I don’t think this is theoretical; this is our lives”: how erasure impacts health care for transgender people. J Assoc Nurses AIDS Care. 2009 Sep-Oct;20(5):348-61; Direct link: http://transpulseproject.ca/research/i-dont-think-this-is-theoretical-this-is-our-lives-how-erasure-impacts-health-care-for-transgender-people/
*Transgender is an umbrella term generally used by some individuals or in reference to their experience of discordance with, and/ or living differently from the gender or sex they were assigned at birth. 
**Gender diverse, gender variant, gender queer, gender independent and gender non-conforming are terms and identities that are commonly taken up by, or used in reference to individuals who in some way do not conform to heternormative sex and gender binaries.  These concepts fall under the Transgender ‘umbrella’ but they do not necessarily infer an individual identifies as transgender.