Pre-Conference andCPATH Conference CONFERENCE 2019 Program - ADVANCING TRANS Programme HEALTH AND WELL-BEING pré-conférence IN CANADA et conférence

conference Join us CPATH 2019 in Montreal! conférence Tiohtià:ke

Joignez-vous www.cpath.ca à nous à Montréal!

October 30 - November 3, 2019 30 octobre - 3 novembre 2019 1 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA CPATH 2019 Conférence

The Canadian Professional Association for Transgender Health Gratefully Acknowledges Our Generous Sponsors C’est avec une grande reconnaissance que l’Association Canadienne des professionnels en santé des personnes transsexuelles remercie nos généreux commanditaires.

CPATH Welcome Reception Sponsor

www.td.com/ca/fr/a-propos-de-la-td/la-promesse-a-agir/

CPATH Friday Plenary Sponsors

www.camh.ca www.grsmontreal.com CPATH Saturday Plenary Sponsor CPATH Sunday Plenary Sponsor

! www.mcmaster.ca www.womenscollegehospital.ca

CPATH Break Sponsor

www.sunlife.ca/barry.zapshalla/e/index.htm

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Message de la mairesse Valérie Plante

Je souhaite la plus cordiale bienvenue à Montréal à toutes les participantes et à tous les participants de la Conférence de l’Association canadienne des professionnels en santé des personnes transsexuelles (CPATH).

Cette conférence offre à Montréal l’occasion de réaffirmer son statut de ville de savoir, grâce aux étudiants, chercheurs et professionnels de la santé, ainsi qu’aux membres des communautés trans, qui ont un intérêt à soutenir la santé des personnes de la diversité sexuelle ou de genre et qui viennent faire part de leurs expertises, de leurs meilleures pratiques et des développements de pointe.

Je vous souhaite une alliance fructueuse entre scientifiques et praticiens, au profit de l’avancement de la recherche et de la santé. À titre de collectivité, nous devons soutenir et reconnaître l’expertise et les innovations qui émergent de ce secteur.

La diversité montréalaise et le bien-être des citoyennes et citoyens sont primordiales pour le développement et le rayonnement de la métropole. Montréal est une ville plus ouverte et inclusive grâce aux gens d’horizons multiples qui la composent. Cette conférence nous rappelle l’importance de célébrer la diversité et les organismes qui, par leurs actions, contribuent à l’épanouissement des personnes LGBTQ+.

Je tiens à saluer les membres et professionnels de la CPATH pour l’organisation de cet événement et pour leurs contributions à améliorer la santé de nos concitoyennes et concitoyens.

Je souhaite également la bienvenue à toutes celles et à tous ceux qui visitent notre belle métropole pour la première fois.

Je vous souhaite une conférence fructueuse et un beau séjour à Montréal.

Valérie Plant MAITRESSE DE MONTRÉAL

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Message from Mayor Valérie Plante

I would like to extend a warm welcome to everyone participating in the Canadian Professional Association for Transgender Health (CPATH) Conference in Montréal.

This conference provides Montréal with an opportunity to reaffirm its status as a city of knowledge, thanks to students, researchers and health professionals, as well as members of trans communities, who have an interest in supporting the health of people of sexual or gender diversity and who come to share their expertise, best practices and cutting-edge developments.

I wish you a fruitful alliance between scientists and practitioners, for the advancement of research and health. As a community, we must support and recognize the expertise and innovations that emerge from this sector.

Montréal’s diversity and the well-being of its citizens are essential to the city’s development and influence. Montréal is a more open and inclusive city thanks to its diverse population. This conference reminds us of the importance of celebrating diversity and the organizations that, through their actions, contribute to the development of LGBTQ+ people.

I would like to salute the members and professionals of the CPATH for organizing this event and for their contributions to improving the health of our fellow citizens.

I also welcome all those who are visiting our beautiful city for the first time.

I wish you a successful conference and a pleasant stay in Montréal.

Valérie Plant MAYOR OF MONTREAL

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Message from the Chair

I am honoured to welcome you all to this celebration of community and knowledge. The CPATH family has grown since its beginnings in 2007 and its vision and direction has taken many turns since then. This is ever so vividly on display during next these few days of pre-conference training and conference.

Much has happened, within the body of CPATH and nationally, since our last conference.

On the national level, we have seen developments in the provision of health care to trans and gender diverse persons in British Columbia as well as in Ontario. Manitoba has recently seen healthcare professionals go to train in surgical procedures abroad. These developments allow trans and gender diverse persons to access care that was previously less available. While we have cause to be heartened, there is much work yet to do. CPATH continues to strive to see equality of access for every trans person in Canada.

In terms of CPATH, in order to continue to strive for the above, we have to continue to look within ourselves as an organization to address what limits the work we do and can do. We must strive to have a body that fully represents all trans persons in Canada. Trans and gender diverse persons must be able to see themselves within us. As such we will learn from the experience of this conference - the academic offerings, the networking, the feeling of community, the failings, and the messages each of these give, to make CPATH more engaged, inclusive and representative.

Please celebrate this conference with us. And from this, let us look forward to the next phase together.

Dr. Michael Marshall, PRESIDENT-ELECT CO-CHAIR MONTREAL

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Message du président

Je suis honoré de vous accueillir toustes à cette célébration de la communauté et du savoir. La famille CPATH s’est agrandie depuis ses débuts en 2007 et sa vision et son orientation ont pris plusieurs formes depuis lors. C’est ce que l’on pourra constater au cours de ces quelques jours de formations préconférence et de conférence.

Il s’est passé beaucoup de choses au sein de la CPATH et à l’échelle nationale, depuis notre dernière conférence.

À l’échelle nationale, nous avons constaté des progrès dans la prestation de soins de santé aux personnes transgenres et de genre divers en Colombie-Britannique ainsi qu’en Ontario. Le Manitoba a récemment vu des professionnels de la santé suivre une formation en chirurgie à l’étranger. Ces développements permettent aux personnes transgenres et de genre divers d’avoir accès à des soins qui étaient auparavant moins disponibles. Bien que nous ayons des raisons d’être réconfortés, il reste encore beaucoup de travail à faire. CPATH continue de travailler à assurer l’égalité d’accès pour toutes les personnes transgenres au Canada.

En ce qui concerne CPATH, afin d’atteindre ce que je viens de nommer, nous devons toujours porter un regard vers l’intérieur en tant qu’organisation dans le but de comprendre ce qui limite le travail que nous faisons et que nous pouvons faire. Nous devons tendre vers un organisme qui représente pleinement toutes les personnes transgenres du Canada. Les personnes transgenres et de genre divers doivent être capables de se voir en nous. À ce titre, nous tirerons des leçons de l’expérience de cette conférence - les présentations académiques, le réseautage, le sentiment d’appartenance à la communauté, les lacunes, et les messages à extraire de chacune de ces dimensions afin de rendre CPATH plus engagée, inclusive et représentative.

Veuillez célébrer cette conférence avec nous. Et à partir de ce moment, fixons ensemble notre regard vers la prochaine étape.

Dr Michael Marshall PRÉSIDENT DÉSIGNÉ COPRÉSIDENT DU COMITÉ CONFÉRENCE MONTRÉAL

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Fostering a Rich Learning Environment

CPATH conferences are known for providing a rich learning environment on several fronts. CPATH is known for curating content at the leading edges of the field, and our conferences bring together professionals – both cisgender and transgender – from a broad range of sectors and disciplines, alongside trans and Two-Spirit1 community members who are working for positive change. Perhaps most importantly, participants are welcoming and inclusive, supportive, and recognize that we each have areas where we can learn and grow, and we each bring something of value, whether as newcomers to gender affirming healthcare, or people who have a decade or more of experience.

Many trans and Two-Spirit people are understandably frustrated and angry about the lack or rate of change they see in systems that can act as oppressive forces on their own and others’ lives. Partners and family members of trans and Two-Spirit people may have witnessed their loved ones struggling with challenges in accessing support and services, and may have experienced similar frustration. Many cisgender people work tirelessly with their trans and Two-Spirit colleagues and with their local trans advocacy and frontline groups to improve health outcomes and to challenge and catalyze change in systems which aren’t currently serving trans and Two-Spirit people well. Some providers may be the only person in their community who is working with trans or Two-Spirit people. And some conference participants – both trans and cisgender, Indigenous and of settler heritage – are brand new to learning about gender affirming healthcare.

As part of contributing to the shared learning environment at the conference, we invite you to consider – and perhaps ask one another – “How do you most hope to learn and grow through participating in this conference? How will you orient yourself to engage with new information? How will you be open to content that may challenge deeply held convictions and ways of functioning?” Gender-related Etiquette

As the conference brings together a breadth of cisgender, trans, and Two-Spirit participants, please do not assume anyone’s gender identity. Please ask about pronouns, especially when speaking of someone in the 3rd person. If in doubt, avoid pronouns or use gender neutral pronouns such as “they”.

Please be aware that washrooms are for everyone and that conference participants are invited to use the washroom that is most comfortable for them. Conference washrooms will be gender neutral.

1. A term used within some indigenous communities, encompassing sexual, gender, cultural, and spiritual identity. Reflects complex indigenous understandings of gender roles and the long history of sexual and gender diversity in indigenous cultures. For more information, see http://transhealth.phsa.ca/trans-101/two-spirit

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Favoriser un environnement d’apprentissage enrichissant

Les conférences du CPATH sont connues pour offrir un cadre d’apprentissage enrichissant à plusieurs niveaux. Le CPATH est connu pour être à la fine pointe dans son champ d’expertise, et nos conférences apportent aussi bien aux professionnels – cisgenres et transgenres – qui couvrent un large éventail de secteurs et de disciplines, qu’aux membres des communautés trans et bi spirituelles. Mais peut-être le plus important, les participants sont accueillants et inclusifs, solidaires, et savent que chacun de nous peut partager une expérience à partir de laquelle nous pouvons tous apprendre et évoluer, peu importe que nous soyons des nouveaux venus dans la volonté d’améliorer la santé des personnes trans, ou que nous ayons des années d’engagement et d’expérience en la matière.

Beaucoup de personnes trans et bi spirituelles sont, avec raison, frustrées et parfois en colère face à la lenteur et/ou au peu de changements. Elles perçoivent cette situation comme des forces oppressives jouant contre elles-mêmes et contre leurs proches. Les partenaires et les familles des personnes trans et bi spirituelles les soutiennent devant les défis auxquels elles doivent se confronter pour avoir accès à du soutien et à des services. Beaucoup de personnes cisgenres travaillent inlassablement avec leurs collègues trans et bi spirituels et avec les organismes trans pour améliorer les résultats, et pour relever les défis rencontrés dans le système qui actuellement ne sert pas adéquatement les personnes trans et bi spirituelles. Quelques fournisseurs de service sont parfois les seules personnes de leur communauté à travailler avec les personnes trans et bi spirituelles. Et plusieurs participants à la conférence, personnes trans et cisgenres, autochtones et non autochtones, en seront à leur première conférence pour en connaître plus.

Comme contribution à ce partage d’un environnement d’apprentissage durant la conférence, nous vous invitons à considérer – et peut-être à ce que chacun se demande – « Qu’est-ce que vous attendez le plus comme apprentissage en participant à cette conférence ? Comment vous engagerez-vous vous-même suite à ces nouvelles connaissances ? Comment envisagez-vous ce défi de remettre en questions des comportements et des convictions profondément ancrées ? » Respecter le genre choisi

Comme la conférence rassemblera un large éventail de personnes cisgenres, trans et bi spirituelles, s’il vous plaît ne présumez pas de l’identité de genre de chacun. Demandez quel pronom vous devez utiliser, spécialement si vous parlez de quelqu’un à la 3e personne.

Veuillez aussi noter que les toilettes seront indifférenciées et les participants à la conférence seront invités à utiliser les toilettes dans lesquelles ils se sentiront le plus à l’aise. Les toilettes de la conférence seront neutres quant au genre.

1 Terminologie utilisée au sein de certaines communautés autochtones qui recouvre l’identité sexuelle, de genre, culturelle, et spirituelle. Il reflète la perception complexe des rôles sexuels et la longue histoire de la diversité sexuelle et de genre dans les cultures autochtones. Pour plus d’information, consultez le site suivant : http://transhealth.phsa.ca/trans-101/two-spirit

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What is a Safer Space?

It is becoming more common for Safer Spaces to be provided at large gatherings focusing on marginalized populations. Many CPATH conference participants may be familiar with the concept of “positive space” which helps to identify spaces and individuals that are welcoming of lesbian, gay, bisexual, transgender, Two-Spirit, and queer people. A Safer Space takes an intersectional approach, recognizing that people may seek spaces that are welcoming not only in relation to sexual orientation and gender identity, but also in relation to many other aspects of peoples’ identities or lived experiences, such as race, ability, class, etc.

At the CPATH conference, we recognize that no space is entirely safe; our aim is to continuously work with people to meet their needs in a “Safer Space”. At the conference, the Safer Space is a place where anyone can relax, can talk about their experiences, and will be welcomed and affirmed whether they are or aren’t a member of trans communities, whether they are Indigenous or are of settler heritage of any race/ethnicity, regardless of sexual orientation, cultural background, religious or spiritual affiliation, age, physical or mental abilities, or their professional or personal roles and affiliations in relation to the health and well-beingSAFER of trans people SPACE and communities. - FRENCH1

The Safer Space: Salon 6

The Safer Space will be available during daytime conference events.

Participants who visit the safer space will notice: • An evolving set of guidelines addressing respect, diversity, and anti-oppression • That the space is located away from the main conference events/activities • The availability of decompression activities, sensory enhancement activities and supplies, educational and identity affirming resources. • That there is an easily identifiable and approachable active listener in the room. These individuals have skills in active listening, verbal and non-verbal communication, confidentiality and problem solving.2, 3 • Opportunities to provide anonymous feedback/expression/reactions in the Safer Space.

1. Opportunities to provide anonymous feedback/expression/reactions in the safer space. Adapted from Advocates for Youth. (2005). 2. Creating Safe Space for GLBTQ Youth: A Toolkit. Washington, DC: Advocates for Youth. http://www.advocatesforyouth.org/publications/publications-a-z/608-creating-safe-space-for-glbtq-youth-a-toolkit The Mental Health Foundation. (2002). Peer Support Manual. London, UK: The Mental Health Foundation. 3. http://www.mentalhealth.org.uk/content/assets/PDF/publications/peer-support-combined. Silverman, R. (2008). Peer Listening. http://www.riseaboveit.org/peer-listening.html

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Qu’est-ce qu’un espace sécuritaire ?

Il est habituel maintenant d’offrir en général des espaces sécuritaires lors de rassemblements qui pourraient susciter de fortes émotions chez les participants. Beaucoup de participants a la conférence du CPATH sont peut-être familiers avec le concept « d’espace positif » qui aide à identifier des espaces collectifs et individuels dans lesquels les lesbiennes, les gais, les bisexuels, les bi spirituels, et les queers sont les bienvenus. Un espace sécuritaire est une approche intersectionnelle, qui reconnaît que des personnes souhaitent des espaces où elles sont les bienvenues en raison de leur orientation sexuelle ou de leur identité de genre, mais aussi avec des personnes partageant leurs origines, ou leur classe sociale, ou encore leur capacité physique ou mentale, etc.

Pendant la conférence du CPATH, nous sommes conscients qu’aucun espace n’est entièrement sécuritaire. Notre objectif est donc de continuellement travailler pour rejoindre les attentes des personnes en matière « d’espace sécuritaire ». Un espace sécuritaire est un endroit où chacun peut relaxer, parler de ses expériences, et se sentir le bienvenu tout en s’affirmant, indépendamment qu’il soit ou non membre des communautés trans, qu’il soit ou non autochtone, qu’il soit ou non d’une minorité racisée ou ethnique, et indépendamment aussi de son orientation sexuelle, de son milieu culturel, religieux, spirituel, de son âge, de ses capacités physiques ou mentales, ou de ses affiliations personnelles ou professionnelles en relation avec la santé et le bien-être des personnes et des communautés trans1.

L’Espace sécuritaire : Salon 6

L’espace sécuritaire sera ouvert toute la journée durant tous les événements de la conférence.

Les participants qui visiteront l’espace sécuritaire remarqueront : • un ensemble de lignes directrices concernant le respect, la diversité, et l’anti-oppression ; • que l’espace est situé loin des activités et des événements de la conférence ; • la mise à disposition d’activités de décompression, d’activités d’amélioration des capacités sensorielles, et des ressources d’éducation et d’affirmation de son identité. • Qu’il y a quelqu’un identifiable et accessible offrant de l’écoute active dans la salle. Ces personnes possèdent des compétences dans la communication verbale et non verbale, la confidentialité et la résolution de problèmes.2, 3 • La possibilité de recevoir de l’aide et du soutien en toute confidentialité.

1. Adapté de : Girl’s Best Friend Foundation and Advocates for Youth. Creating Safe Space for GLBTQ Youth: A Toolkit. Washington, DC: Advocates for Youth, 2005. http://www.advocatesforyouth.org/publications/publications-a- z/608-creating-safe-space-for-glbtq-youth-a-toolkit. 2. The Mental Health Foundation. Peer Support Manual. London, UK: The Mental Health Foundation, 2002. https://www.mentalhealth.org.uk/file/1286/download?token=dhRMpN1b. 3. Silverman, R. et H. Reynolds. Peer Listening. https://web.archive.org/web/20120315140749/http://riseaboveit.org/ peer-listening.html.

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Acknowledgements

CPATH is committed to providing conference content in English and French. Unfortunately, although we are committed to providing simultaneous interpretation for the entire conference, implementing full English/French/English language access is a complex and expensive process, and requires financial resources currently beyond CPATH’s reach.

The CPATH 2019 Conference will be providing simultaneous interpretation in all sessions held in room 7F Ballroom Centre.

The Montreal 2019 CPATH Conference, Advancing Trans Health and Well-Being in Canada, acknowledges and thanks the Conference Planning Committee and additional volunteers for their extraordinary time and contributions to the task of organizing this year’s conference:

CPATH Board Members Lee Allard (AB) - Member at Large Michael Marshall MD (AB) - President Elect Daphné Cloutier MD (QC) - Member at Large Michael Marshall MD (AB) - Treasurer (Oct. 2017-Nov. 2019) Ray Croy - Member at Large Amelia Thorpe - Secretary/Communications (Oct. 2017-Jan. 2019) Janine Farrell (BC) - Member at Large Jack Woodman - President ND, MHSc, CHE (ON) (Oct. 2017-Oct. 2019) Percy Lezard - Member at Large

Conference Planning Committee: Alexandre Baril Richard Montoro (Past) Julie Temple Newhook (Past) Lorraine Grieves Annie Pullen-Sansfacon Amelia Thorpe (Past) Jennifer Ho Marjorie Rabiau Jack Woodman - Co-Chair (Past) Gin Marshall Stephanie Shostak - Co-Chair (Current) Michael Marshall - Co-Chair (Current) Francoise Susset

Safer Space Steward: Nicholas McGrath Submission Review Process: Alexandre Baril Devon MacFarlane Marjorie Rabiau Chris Chapman Kimberley Manning Sam Singer Ray Croy Gin Marshall Francoise Susset Lorraine Grieves Annie Pullen Sansfacon Marria Townsend Percy Lezard Jake Pyne Jack Woodman

Translation: Siobhan Morgulis Translation Services, Dalys Dallaire Translation

2019 CPATH Conference Coordinator: Gin Marshall, Conference Planner

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Remerciements

CPATH est engagé à fournir un contenu de la conférence en anglais et en français. Malheureusement, bien que nous souhaiterions assurer l’interprétation simultanée pour l’ensemble de la conférence, la mise en oeuvre d’une interprétation anglais / français / anglais représente un processus complexe et coûteux, et nécessite des ressources financières actuellement au-delà de la portée de la CPATH.

La conférence CPATH 2019 offrira des services d’interprétation simultanée pour toutes les séances tenues dans la salle 7F Ballroom Centre.

La Conférence 2019 de la CPATH, Promouvoir la santé et bien-être des personnes transgenres au Canada, reconnaît et remercie le Comité de planification et autres bénévoles pour leurs contributions extraordinaire à la mise sur pied de la conférence de cette année :

Membres du conseil d’administration de CPATH : Lee Allard (AB) - Member at Large Michael Marshall MD (AB) - President Elect Daphné Cloutier MD (QC) - Member at Large Michael Marshall MD (AB) - Treasurer (Oct. 2017-Nov. 2019) Ray Croy - Member at Large Amelia Thorpe - Secretary/Communications (Oct. 2017-Jan. 2019) Janine Farrell (BC) - Member at Large Jack Woodman - President ND, MHSc, CHE (ON) (Oct. 2017-Oct. 2019) Percy Lezard - Member at Large le Comité de planification : Alexandre Baril Richard Montoro (Past) Julie Temple Newhook (Past) Lorraine Grieves Annie Pullen-Sansfacon Amelia Thorpe (Past) Jennifer Ho Marjorie Rabiau Jack Woodman - Co-Chair (Past) Gin Marshall Stephanie Shostak - Co-Chair (Current) Michael Marshall - Co-Chair (Current) Francoise Susset

Coordination de l’espace sécuritaire : Nicholas McGrath Comité d’évaluation des soumissions : Alexandre Baril Devon MacFarlane Marjorie Rabiau Chris Chapman Kimberley Manning Sam Singer Ray Croy Gin Marshall Francoise Susset Lorraine Grieves Annie Pullen Sansfacon Marria Townsend Percy Lezard Jake Pyne Jack Woodman

Traduction : Siobhan Morgulis Services de Traduction, Dalys Dallaire Services de Traduction

Coordination de la conférence 2017 de la CPATH : Gin Marshall, Plannificateurs de conférences

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CPATH Pre-Conference Program

Wednesday, October 30 and Thursday October 31, 2019

• Repères de développement en matière d’identité de genre et d’expression de genre; Wednesday, October 30, 2019 • Problèmes sociaux rencontrés par les enfants et les jeunes trans et leur famille; • Aborder les identités diverses, trans et de genre, dans une 7:45 am – 8:45 am Breakfast perspective multidisciplinaire et multisectorielle; 9:00 am – 10:00 am Session • travailler avec les parents et les familles, 10:00 am – 10:30 am Break • travailler avec les écoles; • évaluer les besoins en matière de suppression de la puberté, 10:30 am – 12:30 pm Session de traitement hormonal et de chirurgies; 12:30 pm – 1:30 pm Lunch Buffet • Rôle et responsabilités des professionnels travaillant avec des enfants et des jeunes trans et des groupes variés, ainsi que 1:30 pm – 3:00 pm Session leurs familles; 3:00 pm – 3:30 pm Refreshment Break 3:30 – 5:00 pm Session Bios des conférenciers : Dr. Annie Pullen Sansfaçon Ph.D éthique, travail social, est professeure titulaire à l’École de travail social de l’Université de SÉANCES DE FORMATION PRÉ-CONFÉRENCE Montréal et titulaire de la Chaire de recherche du Canada sur les enfants transgenres et leurs familles. Depuis 2010, elle a Enfants et jeunes 1, français (Session 1 – FR): consacré une grande partie de son temps de recherche à divers projets visant à mieux comprendre l’expérience des jeunes trans 1. Intervention auprès des enfants et des et de leurs familles. Elle est coauteure du livre “Supporting Trans jeunes trans et de la diversité des genres, and Gender Creative Youth: Schools, Families, and Communities et de leur famille in Action” (Peter Lang, 2014 et édition révisée en 2018) et est l’une des cofondatices de l’organisme Enfants transgenres Objectifs: Canada, un organisme communautaire basé à Montréal travaillant 1- Les participants développeront une compréhension des avec les enfants et les jeunes trans et leurs familles. problèmes rencontrés par cette population, ainsi que de leur besoin et ceux de leur famille. Françoise Susset, Psy.D est psychologue et thérapeute conjugale 2- Les participants développeront leur capacité à accompagner et familiale avec plus de 25 ans d’expérience dans le travail les enfants, les jeunes et leurs familles dans divers contextes auprès des individus, des couples et des familles LGBT. Elle tels que les écoles, les services sociaux et les établissements s’intéresse tout particulièrement à l’évaluation et au suivi clinique de santé. des adultes et des adolescentes trans, durant et au-delà de la transition. Elle est spécialisée également dans le soutien Niveau d’expérience: tous niveaux aux familles dont l’enfant exprime son genre de manière non Description: normative (gender expansive children) afin d’aider les familles Cette formation d’une journée offerte en français (mercredi 30 et les écoles à remettre en question des notions associées à la octobre) et en anglais (jeudi 31 octobre) est conçue pour outiller sexualité, l’orientation sexuelle, l’identité de genre et l’expression les professionnels de la santé, de la santé mentale et des services de genre. Elle enseigne dans le programme de thérapie conjugale sociaux à travailler avec des enfants et des jeunes transgenres et et familiare de l’Université McGill. Elle est membre de la WPATH de la diversité des genres, ainsi que leur famille. et ancienne présidente de CPATH.

Contenu: Dr. Shuvo Ghosh M.D., est codirecteur du Centre de santé Cette formation se base sur les meilleures pratiques pour travailler Meraki et directeur du programme pédiatrique de variance avec les enfants et les jeunes trans ainsi que leur famille, dans du genre de Montréal basé au Centre de santé Meraki et à une perspective d’affirmation du genre. Les sujets suivants seront l’Université McGill. Il a accompli la majorité de ses études abordés: aux États-Unis avant d’arriver au Canada dans le cadre d’une

13 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA bourse de spécialisation en pédiatrie du développement et du gender diverse and trans children and youth and their families comportement à l’Université McGill / Hôpital de Montréal pour from a transaffirming perspective. enfants. Après un diplôme de premier cycle en biologie et en Content: études linguistiques hispaniques/italiennes à la John Hopkins This training will focus on best practices for working with gender University de Baltimore dans le Maryland, il a obtenu son diplôme diverse and trans children and youth, and their families, from de médecine à l’University of Illinois at Chicago Medical School, a transaffirming perspective, and will include the following topics: suivi d’une résidence en pédiatrie à la Georgetown University de • Developmental landmarks in gender identity, gender Washington. expression; Antoine Beaudoin Gentes est le chargé de projet d’Enfants • Social issues experienced by trans and gender diverse children transgenres Canada, un organisme communautaire de référence and youth and their families; basé à Montréal qui lutte activement pour soutenir, outiller et • Approaching trans and gender diverse identities from a multi- protéger les enfants transgenres, non binaires, fluides sur le disciplinary and multi-sectoral perspective; plan du genre et leurs familles. Également superviseur artistique • Working with parents and families; du programme Espace Transition du CHU Sainte-Justine, son • Working with schools; implication vise à favoriser l’inclusion des jeunes stigmatisé.e.s au • Assessing needs in regard to puberty suppression, hormone sein de la société. Acteur professionnel de formation, il co-dirige treatment and surgery; aussi le collectif artistique queer et féministe projets hybris avec • Roles and responsibilities of professional working with gender lequel il participe à différentes productions sur scène et dans les diverse and trans children and youth, and their families. lieux publics. Faculty: Denise Medico, Ph.D., est professeure au département de Dr. Annie Pullen Sansfaçon is a Full Professor of Social Work at Sexologie de l’Université du Québec à Montréal. Ses activités the University of Montreal and the holder of the Canada Research de recherche visent le développement de pratiques cliniques Chair on transgender children and their families. She has affirmatives et réflexives. Elle est aussi psychologue au Centre published several book chapters and articles on the experience de santé Méraki et sexologue. Elle a collaboré à la création et au of trans youth and their families, as well as on trans-affirming développement de la Fondation Agnodice en Suisse qui, depuis practices, stressing the importance of social changes in order to 12 ans, œuvre pour la défense des droits des personnes trans et ensure trans youth well-being. She is the coauthor of the book le développement de pratiques affirmatives. Elle est l’auteure du “Supporting Trans and Gender Creative Youth: Schools, Families, livre Repenser le genre: une clinique avec les personnes trans and Communities in Action” (Peter Lang, 2014 and revised edition (Georg 2016), ainsi que de plusieurs articles et chapitres de livre in 2018) and is one of the co-founders of Gender Creative Kids sur l’expérience des personnes trans et la psychothérapie. Elle est Canada, a Montreal-based community organization working with membre du comité scientifique de la WAS (world association for trans children and youth and their families. sexual health). Dr. Shuvo Ghosh is one of the two Co-Directors of the Meraki PRE-CONFERENCE TRAINING SESSIONS Health Centre and the head of the Montréal Pediatric Gender Variance Program based at Meraki and at McGill University. He Children and Youth 1, French (Session 1 – FR): completed the majority of his education in the USA before arriving in Canada to do his fellowship in Developmental-Behavioural 1. Working with Trans and Gender Diverse Pediatrics at McGill University/Montréal Children’s Hospital. After Children and Youth and Their Families an undergraduate degree in Biology and Hispanic/Italian Linguistic Studies at Johns Hopkins University in Baltimore, Maryland, he Objectives: obtained his medical degree at the University of Illinois at Chicago 1. Participants will develop an understanding of the issues faced Medical School, followed by residency in Pediatrics at Georgetown by, and the needs of gender diverse and trans children and University in Washington, DC. youth, and their families. Antoine Beaudoin Gentes is the project coordinator for Gender 2. Participants will develop their ability to support children, youth Creative Kids Canada, a Montreal-based community organization and their families in various environments such as schools, that actively support, equip and protect transgender, non-binary, social services, and health settings. gender creative children and their families. He is also the artistic Experience level: All levels. supervisor of the Espace Transition program at CHU Sainte- Justine where he pursues his involvement that aims to promote Description: the inclusion of stigmatized youth in our society. Trained as a This one-day training offered in French (Wednesday 30th October) professional actor, he co-directs the queer and feminist art and in English (Thursday 31st October) is designed to initiate collective projets hybris with whom he participates in various health, mental health and social care professionals to working with productions on stage and in public spaces. 14 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

2. Primary Care and Informed Consent Andrée-Anne Talbot, MD. is a family physician with a degree from Approaches in Transgender Health the University of Montreal. She has been following transgender and non-binary people in Montreal using an informed consent (Session 2 - EN) approach since 2013, and works in hospitalization at Barrie Please note that this 2 day training includes the Memorial Hospital in Ormtown. ½ day pre-conference training entitled: Gender Affirming Charles-Olivier Basile, MDCM. is a family physician who graduated Surgeries: Exploring Options and Post-Op Care from McGill University. He has been following transgender Objectives: and non-binary people in Montreal using an informed consent 1. Participants will be able to apply an informed consent approach approach since 2017. He also works in palliative care in Montreal. in assessing the needs of trans and non-binary individuals Devon Simpson, MSW is a long-term Montreal based community wishing to access transition-related care worker, trans health advocate and harm reduction worker working 2. Participants will develop their ability to accompany individuals with queer, trans, non-binary and questioning people and their questioning their transition or wishing to reverse some or all families (both chosen and of origin). They have worked in a variety aspects of their transition. of settings including the Gender Advocacy Centre, Project 10 and Head & Hands. With a specific focus on ensuring access Intermediate, some experience in trans health Experience level: to support and care for people in the trans community, Devon recommended currently holds a clinical social work position at Clinique 1851 Description: (CIUSSS du Centre-Sud-de-l’Île-de-Montréal) facilitating access to This 2 day training is designed for all health and mental health trans affirmative health care services. professionals involved in assessing the needs of trans and Daphney Prophète, BScN. is a Clinical Consultant and non-binary individuals wishing to access gender-affirming care. Organizational Development specialist and a member of Drs Many clinicians are committed to moving away from a gatekeeping Brassard, Bélanger and Bensimon’s medical team at the role but still struggle with what approach to adopt that respects Montreal Surgical Center. She, along with Henri Labelle, is one of and prioritizes their client’s needs while considering the various the liaison professionals connecting with clinicians and patients potential risks to an individual that presents with a more complex requiring information and support. mental health/health profile. Henri Labelle, BSW. is a social worker and psychotherapist and Content: a member of the Montreal Surgical Center team. He, along with This training will focus on best practices from an informed Daphney Prophète, is one of the liaison professionals connecting consent perspective and will include the following topics: with clinicians and patients requiring information and support.

• Acknowledging and reducing sources of minority stress; • Supporting trans and non-binary individuals with greater mental 3. Overlapping Spectrums: Gender Diversity health and medical challenges; and Neurodiversity (Session 3 – EN) • Challenging DSM and ICD classification Description: • Defining “informed consent” in health and mental health Current research and clinical practice have identified an emerging settings; overlap of gender diversity with various neurodiversities. Clinicians • Addressing the needs of individuals wishing to detransition, in trans health are often tasked with supporting clients who identify retransition or who regret aspects or their entire transition; as trans who may also be autistic, have ADHD, or experience • Role and responsibilities of mental health providers; intellectual, sensory, or social differences. This workshop will focus • Role and responsibilities of medical providers. on assessment within these overlapping spectrums, provide support Faculty: in clarifying social and medical transition needs for gender diverse Françoise Susset, Psy.D. is a clinical psychologist and couple and and neurodiverse clients, review at a high level some recent research family therapist. Her current focus is working with gender diverse in this field, and provide participants with tools and frameworks for children, youth and their families, and helping schools challenge supporting trans neurodiverse clients with preparation for social and notions regarding sexuality, sexual orientation, gender identity and medical transition. gender expression. Françoise is responsible for the training and clinical supervision of many clinicians across Canada wishing to Faculty: integrate transgender health in their practice. She teaches in the Ashleigh Yule is a registered psychologist and doctoral candidate McGill University M.A. program in Couple and Family therapy and in school/applied child psychology. She specializes in child and is past president of CPATH. adolescent mental health with a focus in transgender health. Ashleigh provides gender affirming counselling, assessment,

15 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA and consultation services for gender creative and transgender children, adolescents, and their families. She works in private Thursday, October 31, 2019 practice in Calgary and as a visiting professional in remote and rural areas of Alberta. She also has a 20-year background in autism assessment, treatment, and research. Her research 7:45 am – 8:45 am Breakfast interests include facilitating health and wellbeing for transgender 9:00 am – 10:00 am Session children and youth, and her dissertation research focuses on the experiences and perspectives of transgender autistic 10:00 am – 10:30 am Break adults. http://www.aycp.ca/ 10:30 am – 12:30 pm Session Noah Adams is a registered Social Worker and PhD student in 12:30 pm – 1:30 pm Lunch Buffet Adult Education and Community Development at the University of Toronto. He conducts research on transgender sucidality and 1:30 pm – 3:00 pm Session the transgender healthcare experiences and strategies of autistic 3:00 pm – 3:30 pm Refreshment Break individuals. Noah is also a transgender and autistic person. 3:30 – 5:00 pm Session http://noahjadams.com/ 5:00 pm – 7:00 pm WELCOME RECEPTION Dr. Bruce Pipher is an Assistant Clinical Professor with the LOCATION: University of British Columbia in the department of psychiatry and Clinical Director of the Interior Health Children’s Assessment Sheraton Club Lounge, Network. He has been practicing and teaching in the field of 37th Floor developmental psychiatry for over 20 years working collaboratively Thank you to Our on a number of mental health initiatives both provincially Welcome Reception Sponsor and nationally. Dr. Pipher provides mental health services to transgender youth in the Interior of BC and working with Transcare PRE-CONFERENCE TRAINING SESSIONS BC on supporting the development and coordination of youth and family friendly services throughout the BC. Children and Youth, English (Session 4 – EN): Lorraine Grieves is a registered clinical counsellor and active 1. Working with Trans and Gender Diverse member of the British Columbia Association of Clinical Counsellors. She has a Master’s degree in Counselling Children and Youth and Their Families Psychology and has been practicing as a helping professional Objectives: since the early 1990’s in a diverse range of roles and programs. 1. Participants will develop an understanding of the issues faced https://www.lorrainegrieves.com/ by, and the needs of gender diverse and trans children and youth, and their families. 2. Participants will develop their ability to support children, youth and their families in various environments such as schools, social services, and health settings.

Experience level: All levels Description: This one-day training offered in French (Wednesday 30th October) and in English (Thursday 31st October) is designed to initiate health, mental health and social care professionals to working with gender diverse and trans children and youth and their families from a transaffirming perspective. Content: This training will focus on best practices for working with gender diverse and trans children and youth, and their families, from a transaffirming perspective, and will include the following topics: • Developmental landmarks in gender identity, gender expression; • Social issues experienced by trans and gender diverse children and youth and their families; • Approaching trans and gender diverse identities from a multi- disciplinary and multi-sectoral perspective; 16 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

• Working with parents and families; 2. Primary Care and Informed Consent • Working with schools; Approaches in Transgender Health • Assessing needs in regard to puberty suppression, hormone treatment and surgery; (Session 5) (Day 2 of 2 - EN) • Roles and responsibilities of professional working with gender Please note that this 2 day training includes the diverse and trans children and youth, and their families.. ½ day pre-conference training entitled: Gender Affirming

Faculty: Surgeries: Exploring Options and Post-Op Care

Dr. Annie Pullen Sansfaçon is a Full Professor of Social Work Objectives: at the University of Montreal and the holder of the Canada 1. Participants will be able to apply an informed consent Research Chair on transgender children and their families. approach in assessing the needs of trans and non-binary She has published several book chapters and articles on the individuals wishing to access transition-related care experience of trans youth and their families, as well as on trans- 2. Participants will develop their ability to accompany individuals affirming practices, stressing the importance of social changes questioning their transition or wishing to reverse some or all in order to ensure trans youth well-being. She is the coauthor of aspects of their transition. the book “Supporting Trans and Gender Creative Youth: Schools, Families, and Communities in Action” (Peter Lang, 2014 and Experience level: Intermediate, some experience in trans health revised edition in 2018) and is one of the co-founders of Gender recommended Creative Kids Canada, a Montreal-based community organization working with trans children and youth and their families. Description: This 2 day training is designed for all health and mental health Françoise Susset, Psy.D is a clinical psychologist and couple and professionals involved in assessing the needs of trans and family therapist. Her current focus is working with gender diverse non-binary individuals wishing to access gender-affirming care. children, youth and their families, and helping schools challenge notions regarding sexuality, sexual orientation, gender identity Many clinicians are committed to moving away from a and gender expression. Françoise is responsible for the training gatekeeping role but still struggle with what approach to adopt and clinical supervision of a great number of clinicians across that respects and prioritizes their client’s needs while considering Canada wishing to integrate transgender health in their practice. the various potential risks to an individual that presents with a She teaches in the McGill University M.A. program in Couple and more complex mental health/health profile. Family therapy. Françoise is past president of the Canadian Content: Professional Association for Transgender Health (CPATH). This training will focus on best practices from an informed Dr. Shuvo Ghosh is one of the two Co-Directors of the Meraki consent perspective and will include the following topics: Health Centre and the head of the Montréal Pediatric Gender • Acknowledging and reducing sources of minority stress; Variance Program based at Meraki and at McGill University. • Supporting trans and non-binary individuals with greater He completed the majority of his education in the USA before mental health and medical challenges; arriving in Canada to do his fellowship in Developmental- • Challenging DSM and ICD classification Behavioural Pediatrics at McGill University/Montréal Children’s • Defining “informed consent” in health and mental health Hospital. After an undergraduate degree in Biology and Hispanic/ settings; Italian Linguistic Studies at Johns Hopkins University in Baltimore, • Addressing the needs of individuals wishing to detransition, Maryland, he obtained his medical degree at the University retransition or who regret aspects or their entire transition; of Illinois at Chicago Medical School, followed by residency in • Role and responsibilities of mental health providers; Pediatrics at Georgetown University in Washington, DC. • Role and responsibilities of medical providers. Antoine Beaudoin Gentes is the project coordinator for Gender Faculty: Creative Kids Canada, a Montreal-based community organization that actively support, equip and protect transgender, non-binary, Françoise Susset, Psy.D. is a clinical psychologist and couple gender creative children and their families. He is also the artistic and family therapist. Her current focus is working with gender supervisor of the Espace Transition program at CHU Sainte- diverse children, youth and their families, and helping schools Justine where he pursues his involvement that aims to promote challenge notions regarding sexuality, sexual orientation, gender the inclusion of stigmatized youth in our society. Trained as a identity and gender expression. Françoise is responsible for professional actor, he co-directs the queer and feminist art the training and clinical supervision of many clinicians across collective projets hybris with whom he participates in various Canada wishing to integrate transgender health in their practice. productions on stage and in public spaces. She teaches in the McGill University M.A. program in Couple and Family therapy and is past president of CPATH.

17 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Andrée-Anne Talbot, MD. is a family physician with a degree Within an informed consent paradigm, clinicians need to have from the University of Montreal. She has been following sufficient knowledge of surgical options and surgical outcomes transgender and non-binary people in Montreal using an to ensure that people seeking such care have expectations of the informed consent approach since 2013, and works in process that is as close as possible to their experience. hospitalization at Barrie Memorial Hospital in Ormtown. Content: Charles-Olivier Basile, MDCM. is a family physician who • Types of gender affirming surgeries graduated from McGill University. He has been following - Preparation transgender and non-binary people in Montreal using an - Surgical process informed consent approach since 2017. He also works in - Post-surgical care palliative care in Montreal. - Expected results • Health, mental health and psycho-social considerations Devon Simpson, MSW is a long-term Montreal based community • Potential barriers to surgeries worker, trans health advocate and harm reduction worker working with queer, trans, non-binary and questioning people Faculty: and their families (both chosen and of origin). They have worked Daphney Prophète, BScN. is a Clinical Consultant in a variety of settings including the Gender Advocacy Centre, and Organizational Development specialist and a member of Project 10 and Head & Hands. With a specific focus on ensuring Drs Brassard, Bélanger and Bensimon’s medical team at the access to support and care for people in the trans community, Montreal Surgical Center. She, along with Henri Labelle, is one of Devon currently holds a clinical social work position at Clinique the liaison professionals connecting with clinicians and patients 1851 (CIUSSS du Centre-Sud-de-l’Île-de-Montréal) facilitating requiring information and support.. access to trans affirmative health care services. Henri Labelle, BSW. is a social worker and psychotherapist and a member of the Montreal Surgical Center team. He, along with Daphney Prophète, BScN. is a Clinical Consultant and Organizational Development specialist and a member of Drs Daphney Prophète, is one of the liaison professionals connecting Brassard, Bélanger and Bensimon’s medical team at the with clinicians and patients requiring information and support. Montreal Surgical Center. She, along with Henri Labelle, is one of the liaison professionals connecting with clinicians and patients requiring information and support. 5:00 pm – 7:00 pm

Henri Labelle, BSW. is a social worker and psychotherapist and WELCOME RECEPTION a member of the Montreal Surgical Center team. He, along with LOCATION: Sheraton Club Lounge, Daphney Prophète, is one of the liaison professionals connecting 37th Floor with clinicians and patients requiring information and support. Thank you to Our Welcome Reception Sponsor 3. Gender affirming surgeries: Exploring options and post-op care (Session 6 – EN)

Objectives: Participants will increase their ability to discuss surgical options and expectations for convalescence with individuals undergoing gender-affirming surgeries.

Experience level: All experience levels

Description: This ½ day training is offered by 2 staff members, a nurse and a social worker, from the Montreal Surgical Center team who work closely with patients before during and following their surgery (https://www.grsmontreal.com/en/home.html)

This training designed for clinicians who meet with trans and non-binary individuals in order to discuss gender affirming surgical options and prepare for the various stages involved in accessing such care.

18 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

CPATH 2019 Conference Program

Friday, November 1 / vendredi 1 novembre, 2019

All Day Registration / Inscription Speakers: Alexandre Baril, Ph.D. in Women’s 7:30 - 8:30 am Breakfast Studies, is an Assistant Professor at the School of Social Work at the University 7:30 - 8:30 am Caucus Opportunities of Ottawa, specializing in diversity, including sexual, gender, (dis)ability, 8:30 - 8:50 am CONFERENCE OPENING and linguistic diversity. Alexandre Baril’s Ceremonial Opening interdisciplinary training combines ten years in philosophy/ethics, a Ph.D. in 8:50 - 9:00 am WELCOME Women’s Studies and two postdoctoral Dr Michael Marshall fellowships in Feminist, Gender, and President-Elect Sexuality Studies at Wesleyan University (Social Sciences and Humanities Research Council/SSHRC Postdoctoral Fellowship),

and in Political Science at Dalhousie University (Izaak Walton 9:00 - 10:30 am OPENING Killam Postdoctoral Fellowship). He has published articles in PLENARY (FR) journals such as Hypatia: Journal of Feminist Philosophy; (service de traduction simultanée au besoin) Feminist Review; TSQ: Transgender Studies Quarterly; Atlantis: Moderator: Gabriel Galantino Critical Studies in Gender, Culture & Social Justice; Frontiers: A Journal of Women Studies; Annual Review of Critical Psychology; Alexandre Baril Medicine Anthropology Theory; Journal of Literary & Cultural Sophie Labelle Disability Studies; Canadian Journal of Disability Studies; Disability Dalia Tourki & Society; Somatechnics; Genre, sexualité & société; Recherches féministes; Enfances, familles, générations: Revue internationale; Leading the Way: Inspiring Community Role Revue Jeunes et Société; Criminologie; Philosophiques and Models and the Paths They’ve Travelled Recherches sociologiques & anthropologiques. His intersectional research places gender, feminist, queer, trans, and disability/crip This opening panel aims to give voice to trans Francophone people studies in dialogue with the sociology of the body, health and social who, through their political, intellectual and artistic contributions, movements. His recent research examines discourses on suicide have contributed, among many other people, to open the path and assisted suicide within anti-oppressive movements/studies. for trans and nonbinary gender communities in the Canadian Sophie Labelle is an internationally Francophonie. In that sense, they represent positive and inspiring renowned visual artist and author from role models for trans and nonbinary communities. Based on the South shore of Montréal. She is the testimonies of their journey, struggles, praxis and political actions transgender cartoonist behind Assigned and on reflections on the state of trans movements and studies Male, a webcomic about a group of in the Canadian Francophonie, this panel with simultaneous queer and trans teenagers that has been interpretation in English represents a unique opportunity to running since 2014 and already touched understand the theoretical and political contributions of trans millions of readers. activists from a specific cultural perspective for the CPATH Dalia Tourki works at the Centre for conference in Montreal. Gender Advocacy, and is a board Moderator: member of LGBTQ action with Gabriel Galantino is a doctoral candidate at the University of Quebec immigrants and refugees (AGIR). She in Montreal and a clinical sexologist at Meraki Health Centre. As a coordinated two academic research trans activist, Gabriel has been engaged at the community level and projects: the first one on the experiences in research since the last year of his bachelor’s degree in sexology. of trans youth aged between 18 and 25 His primary research focus is on the realities of trans youth, more years old, and the second is about the specifically on their access to resources, their vulnerabilities and realities of racialized LGBTQ migrants. resiliency, sexuality, and the affirmative clinical approaches to gender. She gives dozens of workshops on trans issues, and recently spearheaded a trial against the government 19 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA of Quebec at the superior court. The trial seeks to invalidate des femmes, ainsi que deux stages postdoctoraux en études 11 provisions of the Civil Code of Quebec that prevent the full féministes, des genres et des sexualités à Wesleyan University participation of trans people in civil society. She is the co-author of (Bourse postdoctorale du Conseil de recherches en sciences two recently-published academic articles. humaines du Canada/CRSH) et en science politique à Dalhousie University (Bourse postdoctorale Izaak Walton Killam). Il a publié 9h00 - 10h30 am OUVERTURE plusieurs articles dans des revues telles que Hypatia: Journal of PLENAIRE (FR) Feminist Philosophy; Feminist Review; TSQ: Transgender Studies (Simultaneous Translation) Quarterly; Atlantis: Critical Studies in Gender, Culture & Social Justice; Frontiers: A Journal of Women Studies; Annual Review Modérateur : Gabriel Galantino of Critical Psychology; Medicine Anthropology Theory; Journal of Alexandre Baril Literary & Cultural Disability Studies; Canadian Journal of Disability Sophie Labelle Studies; Disability & Society; Somatechnics; Genre, sexualité & Dalia Tourki société; Recherches féministes; Enfances, familles, générations: Revue internationale; Revue Jeunes et Société; Criminologie;

Philosophiques et Recherches sociologiques & anthropologiques. Ouvrir la voie : le cheminement inspirant de Ses recherches intersectionnelles se situent à la croisée des personnes modèles dans nos communautés études de genre, queer, trans, du handicap et de la sociologie

Ce panel d’ouverture vise à donner la voix à des personnes du corps, de la santé et des mouvements sociaux. Ses travaux trans francophones qui, par leurs contributions politiques, récents se penchent sur les discours tenus sur le suicide et intellectuelles, artistiques, ont contribué, parmi un ensemble le suicide assisté au sein des mouvements et des études anti- d’autres personnes, à ouvrir la voie aux communautés trans et oppression. non binaires de genre dans la francophonie canadienne. Sous Sophie Labelle est un artiste visuel cet angle, ces personnes servent de modèles positifs et inspirants et auteur reconnu internationalement pour les communautés trans et non binaires. Basé sur des de la Rive-Sud de Montréal. Elle est témoignages de leur parcours, de leur cheminement, de leurs la caricaturiste transgenre derrière luttes, de leurs praxis et actions politiques et sur des réflexions sur Assigned Male, une bande dessinée en l’état des mouvements et des études trans dans la francophonie ligne au sujet d’un groupe d’adolescents canadienne, ce panel avec interprétation simultanée en anglais homosexuels et transsexuels qui court représente une occasion unique de comprendre les apports depuis 2014 et qui rejoint déjà des théoriques et politiques des activistes trans à partir d’un ancrage millions de lecteurs. culturel spécifique pour édition de la conférence du CPATH à Montréal. Dalia Tourki travaille au Centre de lutte contre l’oppression des genres Moderator: et fait partie du C.A. d’Action LGBTQ Gabriel Galantino est candidat au doctorat à l’Université du Québec avec Immigrant.e.s et Réfugié.e.s à Montréal et sexologue clinicien au Centre de Santé Meraki. Homme (AGIR). Elle a coordonné deux projets trans militant pour les droits de sa communauté, Gabriel s’implique au de recherche académique : l’un sur niveau communautaire et en recherche depuis sa dernière année de les expériences des jeunes trans baccalauréat en sexologie. Ses intérêts de recherche portent sur les âgées entre 18 et 25 ans, et l’autre réalités des jeunes trans, plus spécifiquement l’accès aux ressources, sur les réalités des personnes LGBTQ les vulnérabilités et la résilience, la sexualité et les approches migrantes et racisées. Elle donne des cliniques affirmative dans le genre. dizaines de conférences sur les enjeux trans, et a récemment mené un procès contre la Procureure Générale du Québec. La poursuite Speakers: cherche à invalider 11 articles du Code Civil qui empêchent la Alexandre Baril, Alexandre Baril, Ph.D. en études des femmes, est professeur pleine participation des personnes trans dans la société civile. Elle adjoint à l’École de service social de est l’auteure de deux articles académiques, récemment publiés. l’Université d’Ottawa et spécialiste de la diversité, incluant la diversité sexuelle 10:30 - 11:00 am Break & EXHIBITS et de genre, corporelle (handicaps et santé) et linguistique. La formation interdisciplinaire d’Alexandre Baril combine dix années en philosophie/ éthique, un doctorat en études

20 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

11:00 am - 12:30 pm Electronic Media and Trans Health Medias électroniques et santé trans CONCURRENT SESSIONS 9F. De nouveaux savoirs experts: Les 92E. The Antiviolence Movement We Want: vidéoblogues sur l’hormonothérapie des Creating Trans-Led Feminist Services hommes trans* et personnes non binaires. (Workshop) (Présentation orale)

Presenters: Presenter: Felix Gilliland, Community Engagement & Inclusion Morag Bosom, Candidate à la maîtrise, département Coordinator, WAVAW Rape Crisis Center, Vancouver, British de sexologie, Université du Québec à Montréal, Columbia Montreal, Quebec Dalya Israel, Executive Director, WAVAW Rape Crisis Centre, Introduction : Les vidéoblogues sont des sources d’informations Vancouver, British Columbia très importantes pour les hommes trans* et personnes non WAVAW Rape Crisis Center is a feminist antiviolence organization binaires qui désirent commencer l’hormonothérapie. Ceux-ci in Vancouver, BC. Previously, WAVAW has been open to all self- se tournent davantage vers ces plateformes qui leur offrent des identified women, but in 2017 we received funding to expand our connaissances alternatives au discours médical. services to people of all marginalized genders: trans and cis Il importe alors de mieux comprendre ce qui est accessible et women, as well as all Two Spirit, trans, and nonbinary people. comment l’expérience de la testostérone est décrite sur ces This workshop will look at our process of community consultation, plateformes en ligne. Méthode: 42 vidéoblogs d’hommes trans* creating trans-specific sexual assault services, and reflecting on et personnes non binaires nord-américains prenant de la feminist praxis in order to offer services that are intersectional testostérone ont été visionnés sur YouTube. Les contenus and relevant. We will review themes from our community abordant la transition avec testostérone sur les plans sensoriel, consultation and workshop participants will work in small groups affectif, identitaire et sur la sexualité ont été sélectionnés et to strategize for implementing our findings in their work. retranscrits en verbatim. Une double analyse a été effectuée pour This workshop will touch on accountability to sex worker approfondir l’expérience subjective individuelle et repérer les communities and Indigenous communities as trans inclusion, in différences et similitudes à travers les témoignages. response to community feedback that most trans inclusion work Résultats : Les vidéoblogues offrent une multitude d’informations centers on white, masculine trans people. It will also explore how concernant la transition avec testostérone et sont une véritable feminists and trans people can work in solidarity and offer vital formation par les pairs. Ils informent de l’expérience de la influences to each other in antiviolence work. testostérone, qui est vécue à travers les divers changements Finally, we will explore our framework for trans inclusion that physiques, émotionnels, relationnels et identitaires auxquels goes deeper than surface-level changes to center the most les témoins donnent sens. L’information accessible est marginalized trans communities in our work, and provide continuellement renouvelée et ancrée dans des témoignages. resources for organizations interested in this work. Une analyse des contenus sera présentée, montrant This workshop will be presented by two staff members from comment l’expérience subjective de la prise de testostérone est WAVAW: Felix Gilliland, our trans inclusion coordinator, and Dalya complexe et ayant des significations allant bien au-delà de ce qui Israel, our executive director. We will use powerpoint, as well as est disponible dans la littérature médicale. small group discussions. Discussion : Ce travail souligne l’importance et le caractère unique et précieux de l’éducation et l’information des personnes trans* et non binaires par des ressources en ligne pour et par les pairs. Ils constituent de nouveaux savoirs experts.,

21 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

12F. TransInclusion : Comment développer to know our queer selves through accessing online information and un sentiment d’appartenance positif chez communities. Our paper examined how online spaces, specifically social media sites such as Tumblr, offer young queer exuality personnes trans envers la communauté education that is largely absent from their lives offline. trans* (Présentation orale) Participants will leave understanding the gaps that exist in queer

Presenter: and trans sexuality education, how colonialism continues to impact Benjamin Drainville, Étudiant, Université du Québec à education, and how collective biography can be used in queer and Montréal, Montréal, Québec trans peer-led research.

Les approches anti-oppressive et transaffirmative encouragent 20E. New Experts Knowledge: Videoblogs les professionnel.le.s à intervenir auprès des personnes trans* en on Hormone Therapy of Trans Men ouvrant et en adaptant leurs services à cette population. Bien que l’attitude des professionnel.le.s de la santé et les services de soins and Non-Binary People (Oral Presentation) proposés aient une influence sur l’état de santé d’une personne Presenter: trans*, il semblerait que peu d’intervention s’adresse directement Morag Bosom, Candidate à la maîtrise, département aux personnes trans* et à leur communauté d’appartenance. de sexologie, Université du Québec à Montréal, Présentement, plusieurs personnes trans (binaire) francophones Montreal, Quebec ne trouvent pas leur place à l’intérieur de la communauté trans* notamment parce qu’elle abrite une multitude d’identités Introduction: Videoblogs are very important sources of information sexuelles et que certains de ses membres sont victimes for trans* men and non-binary people who want to start hormone ou auteurs d’oppressions diverses. Il apparaît donc nécessaire de therapy. They are turning more to these platforms that offer them proposer aux professionnel.le.s des milieux communautaires des alternative knowledge to medical discourse. It is important to better pistes d’interventions favorisant le développement d’un sentiment understand what is accessible and how the testosterone experience d’appartenance positif des personnes trans envers la is described on these online platforms. Method: 42 videos of North communauté trans*. Le projet innovateur TransInclusion American trans* men and non-binary people taking testosterone encouragera les jeunes trans francophones âgé.e.s entre 15 et were viewed on YouTube. The contents dealing with the transition 25 ans à explorer leur identité et à connaître la communauté with testosterone on sensory, affective, identity and sexuality levels trans* en amenant 6 à 12 personnes trans à réfléchir et à were selected and transcribed in verbatim. A double analysis discuter ensemble, par la médiation de sexologues, à propos de was carried out to deepen the individual subjective experience and l’histoire trans*, des communautés de la diversité sexuelle, des identify the differences and similarities through each testimony. caractéristiques identitaires et de leur sentiment d’appartenance Results: Videoblogs offer a wealth of information regarding the envers la communauté trans*. Ce projet d’intervention ‘’par transition with testosterone and are a true peer training. They et pour’’ de 10h servira à guider et à soutenir la construction inform about the experience of testosterone, which is experienced identitaire des jeunes trans francophones selon leur identité through various physical, emotional, relational and identity changes sexuelle, leurs besoins et leurs communautés d’appartenance. to which trans* men and non-binary people give meaning. Accessible information is continually renewed and anchored in 15E. Everything We Learned About Being testimonials. An analysis of the contents will be presented, showing Queer, We Learned from the Internet how the subjective experience of taking testosterone is complex and having meanings going well beyond what is available in the (Oral Presentation) medical. Presenters: Discussion: This work highlights the importance and the unique Jamie Anderson, MA Student, Educational Research, and valuable nature of education and information of trans* and University of Calgary, Calgary, Alberta non-binary people through online resources for and by peers. They Emilie Maine, Student, MA Student, Educational Research, constitute new expert knowledge. University of Calgary, Calgary, Alberta ------This oral presentation draws on our paper “Everything We Learned About Being Queer, We Learned from the Internet”, and will discuss how co-collaboration through collective biography can be used as a form of transformative activism. Using collective biography in our research we centered our lives and our voices as queer individuals, allowing us to “write from the body” in order to make visible and interrogate dominant discourses that we are entangled within. Our paper drew on our pivotal lived experiences in coming

22 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

59E. Evolving Approaches to the Development 61E. Parents, Caregivers, and Families of and Application of Clinical Skills (Workshop) Trans and Non-binary Youth in Clinical Care: New Research from the Stories of Care Presenter: Silvana Hernando, Clinical Educator, Rainbow Health Ontario, Project and Trans Youth CAN! (Panel)

Sherbourne Health, Toronto, Ontario Facilitator: Dr. Annie Pullen Sansfacon, Professor of Social Work, Rainbow Health Ontario (RHO), a program of Sherbourne Health, University of Montreal, Montréal, Québec has been providing training on trans and LGBT2SQ health for over Panelists: 10 years. RHO’s approach is evolving to more robustly support Julie Temple-Newhook, Professional Associate, Memorial health care providers’ learning needs. This session will outline University, St. Johns, Newfoundland RHO’s enhanced and new directions: the development of new Valeria Kirichenko, Master’s student, School of Social Work, training content, new approaches to consultation and mentorship, University of Montreal, Montreal, Quebec and the development of online learning modules. Greta Bauer, Professor, Epidemiology and Biostatistics, Western University, London, Ontario 60E. FOR US AND FROM US: Exploring Skipping Stone’s Innovative Parents, caregivers and families of trans youth have a range of experiences as their youth come out to them and navigate the Community-Driven, Comprehensive process of seeking and obtaining gender-affirming care. We present Care Model (Panel) and discuss results about parents, caregivers, and families of trans youth attending Canadian clinics. Data come from two companion Facilitator: Amelia Marie Newbert, Executive Director, Skipping Stone, studies: the Stories of Care project, a qualitative study of trans Calgary, Alberta youth and their parents/caregivers, and Trans Youth CAN!, a Panelists: quantitative study of trans youth (and their parents/caregivers) Lindsay Peace, Director, Community Programs, Skipping referred to clinics for puberty suppression or hormones. Stone, Calgary, Alberta Semi-structured interview data were collected from parents of Dr. Ted Jablonski, CCFP, FCFP, Medical Director, Skipping youth at all stages of care at three clinics in Montreal, Ottawa, and Stone, Calgary, Alberta Winnipeg. Baseline survey data (part of an ongoing cohort study) Ashleigh Yule MA, RPsych; Lead Psychologist, Youth, Skipping were collected by self-completed surveys from parents of youth at Stone, Calgary, Alberta the time of first visit for puberty suppression or hormone therapy at Johnathan Kuipers RSW, Supervisor, Group Programs, 10 clinics in Halifax, Montreal, Ottawa, Toronto, Hamilton, Skipping Stone, Calgary, Alberta London, Winnipeg, Edmonton, Calgary, and Vancouver. All clinics are gender-affirming, in the sense that they provide children and Three years ago, a handful of people who were a part of the trans youth the opportunity to live in and express the gender that is and gender diverse community huddled around a kitchen table and most comfortable for the child without restriction or criticism. asked a simple question: if there was a way we could access the We present results on parents’/caregivers’ levels of gender support services and supports that we need, in the way that we’d want for their youth at the time of coming out to the present, degree of them delivered... What would that look like? Fast forward to today, concordance between parent/caregiver and youth reports of Skipping Stone is providing trans and gender diverse individuals support, and describe the varied processes parents/caregivers and their families across the province, low-barrier access to traverse. We report on frequencies that families experience external community and social support as well as mental health and medical stressors related to their youth’s gender, such as critiques of their services through an integrated and comprehensive model that parenting, other parents not letting kids come to their house, or continues to be led and directed by members of the community. having to advocate for their child’s rights to access gendered spaces, The passionate founders, along with contributing members from and we explore how parents/caregivers and families respond to across the various disciplines within Skipping Stone will share these stressors in ways that may challenge or ultimately strengthen their insights and learning gained through the trials, tribulations and family functioning. We consider sources of support reported by ultimate success of this unique and meaningful organization. parents/caregivers, and provide insight into their needs. We explore parent/caregivers experiences at the clinics and discuss how we can better support parents to better affirm their children and to care for their own and their families’ well-being.

23 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

3F. Pour en finir avec la psychiatrisation des and non-binary people. At the end of 2014, the WHO commissioned identités de genre : une expérience et une a study on the diagnosis of gender incongruence through the WHO collaborating centre in Lille, France. The chosen Centre was the étude françaises (Présentation en groupe) MDS. The study completed in 2018, is tailored on an international (Simultaneous Translation) study conducted in six other countries. The results put into question the systematic presence of distress and functional disability for all Facilitators: Marie de la Chenelière, maîtrise de psychologie, trans people, as well as trans identities being in and of themselves psychopraticienne de la relation d’aide, experte a source of distress. It addresses the fact that this suffering is often d’expérience the result of rejection and stigmatization. Marie-Jeanne Martin, Dre, Ordre des médecins, France Bertrand Riff, Docteur, Ordre des médecins, France 12:30 - 1:30 pm Lunch & EXHIBITS

Pour en finir avec la psychiatrisation des identités de genre : une 1:30 - 2:00 pm POSTER SESSIONS expérience et une étude françaises La Maison Dispersée de Santé with Authors Present (MDS, maison médicale pluriprofessionnelle)* considère que ______toutes personnes, soignantes et patient.e.s, sont dépositaires d’une expertise qui se partage et permet d’élaborer ensemble POSTER SESSIONS l’accompagnement. La personne qui souhaite accéder aux services For List of Poster Sessions and Descriptions agit comme maître de son projet de transition et de soin et la MDS comme soutien et accompagnatrice. Il s’agit d’un modèle see page 58. de décision médicale partagée où le consensus est recherché. ______La décision est centrée sur la réalité des personnes concernées, notamment des personnes trans et non binaires. Fin 2014, l’OMS a commandité une étude sur le diagnostic d’incongruence de 2:00 - 3:30 pm genre au CCOMS (Centre Collaborateur de l’OMS) de Lille. Le terrain d’étude choisi a été la MDS. L’étude achevée, en 2018, CONCURRENT SESSIONS est une réplique d’une étude internationale menée dans six pays. Les résultats remettent en cause l’existence systématique d’une 93E. Advancing Assessment Practices With détresse et d’un handicap fonctionnel chez toutes les personnes Trans and Gender Diverse Children, Youth transgenres, ainsi que les identités trans et non binaires and Their Families: Introducing a New comme source de cette détresse. Elle aborde le fait que Framework and Practice Tools (Workshop) cette souffrance trouve souvent son origine dans le rejet et la stigmatisation. La présentation proposée est le retour d’un travail Presenters: collaboratif de praticiens et de personnes trans et non binaires sur Lorraine Grieves, Provincial Program Director, Trans Care BC, l’une des études ayant servi à la déclassification du transsexualisme Registered Clinical Counsellor, Vancouver, British Columbia et de ce que pourrait être un accompagnement dépsychiatrisé dans Dr. Bruce Pipher, Psychiatrist and Assistance Clinical le cadre de la nouvelle CIM. *La MDS est un lieu de soins créé Professor, University of British Columbia; Clinical Director, en 1986 et un centre d’enseignement universitaire de médecine Interior Health Children’s Assessment Network; Transcare de proximité (professions médicales et paramédicales). Elle s’est BC, Vancouver, British Columbia impliquée dans des problèmes de société (IVG, VIH, toxicomanie, Dr. Beth Clark, Post Doctoral Fellow, Registered Clinical travail du sexe…). Elle accueille des personnes trans et non binaires Counsellor, Boston, Massachusetts depuis une dizaine d’années (File active d’environ 400 personnes Dr. Pam Narang, Registered Psychologist, Registered en 2019). Psychologist, Vancouver, British Columbia ------Dr. Marria Townsend, Medical Director, Physician, Vancouver, For an end to the pathologizing of trans identities: A French British Columbia experience and study The MDS (Multiprofessional Medical Center)* considers that all persons, caregivers and patients, possess an Services and supports needed by trans and gender diverse expertise which is shared and makes it possible to work from a children, youth and their families are wide-ranging. These can consensus- based approach. The person seeking services is the include general and mental health care, gender-specific health one in charge of the project and the MDS provides support and care such as puberty blockers or hormone therapy, and other accompaniment throughout the project. It is a model of shared supports related to housing, education, relationships, and culture. medical decision making where consensus is sought. The decision Unique and significant barriers to needed care include cost, is centered on the reality of the people concerned, that is on trans previous negative experiences, concerns about uneducated providers, inconsistently applied protocols, lack of care

24 CPATHCPATH CONFERENCE CONFERENCE 2019 2019 - -ADVANCING ADVANCING TRANS TRANS HEALTH HEALTH AND AND WELL-BEING WELL-BEING IN IN CANADA CANADA coordination,timely gender-affirming and limited/delated care. These access resources to care. align An increasewith health in 63E.63E. TheThe CanadianCanadian TransTrans YouthYouth HealthHealth service requests across Canada is necessitating action to address care practices in British Columbia, which emphasize bringing Surveys,Surveys, 20142014 && 2019:2019: ChangesChanges inin gapsquality in carecare. closer While tomany home express through interest delivery in providingof the right this care, at the TransTrans andand Non-BinaryNon-Binary YouthYouth HealthHealth andand care,right potentialtime, in the providers right place, frequently by the report right person.being uncertain The Trans of Caretheir Experiences in Canada (Panel) role.BC team Trans will Care overview BC has a thereforedraft child, partnered youth and with family youth, families Experiences in Canada (Panel) and expert clinicians to develop an assessment framework and psychosocial/mental health assessment framework conceptualizing Presenters:Presenter: practice support tools to support the provision of effective and basic to advanced care delivery across a range of contexts; Dr.Dr. ElizabethElizabeth Saewyc,Saewyc, (Professor(Professor && Director),Director), StigmaStigma andand timely gender-affirming care. These resources align with health a screening supplement tool with guidance notes to support ResilienceResilience AmongAmong VulnerableVulnerable YouthYouth Centre,Centre, SchoolSchool ofof care practices in British Columbia, which emphasize bringing assessment of gender-specific bio-psycho-social-spiritual/cultural Nursing,Nursing, UniversityUniversity ofof BritishBritish Columbia,Columbia, Vancouver,Vancouver, BritishBritish quality care closer to home through delivery of the right care, at the strengths and needs; and a semi-structured interview guide for ColumbiaColumbia right time, in the right place, by the right person. The Trans Care advanced practice clinicians. Learning objectives for this session Dr.Co-presenter: Ashley Taylor, (Postdoctoral fellow), Stigma and Resilience BC team will overview a draft child, youth and family include: conceptualizing the planning and delivery of gender- Dr.Among Ashley VulnerableTaylor, (Postdoctoral Youth Centre, fellow), School Stigma of Nursing, and Resilience psychosocial/mental health assessment framework conceptualizing affirming health and support services using a holistic approach; UniversityAmong Vulnerable of British YouthColumbia, Centre, Vancouver, School of British Nursing, Columbia basic to advanced care delivery across a range of contexts; improving understanding of screening and assessment specific to University of British Columbia, Vancouver, British Columbia agender screening health supplement needs; and tool enhancing with guidance skills related notes toto supportscreening and Five years ago, in 2014, we conducted the first federally funded assessmentassessment. of Feedback gender-specific from this bio-psycho-social-spiritual/cultural session will inform revision of these nationalFive years Canadian ago, in 2014,Trans Youthwe conducted Health Survey the first as anfederally online funded survey. strengthsresources, and as partneeds; of broaderand a semi-structured work being undertaken interview to guide clarify for and Morenational than Canadian 900 young Trans people Youth ages Health 14-25 Survey across as allan provinces online survey. advancedstrengthen practice care pathways clinicians. for transLearning and objectivesgender diverse for this children, session andMore territories than 900 (except young Yukonpeople and ages Nunavut) 14-25 across participated. all provinces Survey include:youth and conceptualizing families in British the Columbiaplanning and deliveryacross Canada. of gender- findingsand territories were (exceptfirst shared Yukon widely and Nunavut)in a report, participated. Being Safe, Survey Being Me, affirming health and support services using a holistic approach; andfindings then throughwere first regional shared reports, widely publishedin a report, journal Being articles,Safe, Being Me, improving understanding of screening and assessment specific to presentations,and then through and regionaleven infographics; reports, published they have journal been articles,used to gender health needs; and enhancing skills related to screening and guidepresentations, school district and even policies, infographics; provincial they laws have and beenregulations, used to assessment. Feedback from this session will inform revision of these healthguide schoolcare, and district even policies, for human provincial rights cases. laws and We regulations,are now resources, as part of broader work being undertaken to clarify and repeatinghealth care, the and survey even after for 5human years, rightswith some cases. new We questions are now strengthen care pathways for trans and gender diverse children, added,repeating to learnthe survey how the after experiences 5 years, with of transsome and new non-binary questions youth youth and families in British Columbia and across Canada. inadded, Canada to learnmay have how changed.the experiences Data collection of trans and will non-binaryend May 31, youth 2019;in Canada to date, may using have the changed. online surveyData collection platform willQualtrics, end May we 31, have already2019; to collected date, using the responsesthe online surveyof more platform than 1,000 Qualtrics, trans andwe have

mieux comprendre pour mieux agir transforming knowledge into action

Jeunestransyouth.ca

2425 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA non-binary youth, representing all provinces and territories. The Structural Violence / Violence Structurelle survey includes questions about a wide range of life experiences and behaviors that influence young people’s health: demographic 110F. Trans en Région c’est Possible ! questions, risk exposures such as violence and discrimination; family relationships, school experiences, access to and (Présentation en groupe) experiences of health care, and a wide range of health topics, Presenters: including mental health, sexual health, substance use, injuries, Louise Lacroix, Coordonnatrice, TRANS-Mauricie/Centre- even sleep! The survey also has questions about protective du-Quebec (organisme communautaire), Trois Riviéres, factors and supports which help promote well-being for young Québec people. For the CPATH conference, our team will present first Maude Bourgeois-Turcotte, Psychologue, Ordre des findings from the survey, sharing information about the lives psychologues du Québec, Drummondville, Québec of trans and non-binary young people all across Canada, with comparisons to the previous survey where questions are the same. Depuis sa création, février 2016, l’organisme est en constant mouvement afin de développer des services dédiés à la 86E. Speaking Truth to Whiteness: population vivant avec la diversité de genre. De mettre en place Unpacking Trauma in the Face of Racism l’accompagnement nécessaires à l’affirmation, l’acceptation et les différents processus de chaque individu. (Workshop) Notre mission de présenter des démystifications de la diversité

Presenters: de genre sur le territoire de la Mauricie et du Centre-du-Québec, Ronnie Ali, Registered Psychotherapist (Qualifying), à la mise sur pieds d’ateliers pour les personnes de la diversité Sherbourne Health, Toronto, Ontario de genre et en questionnement ainsi que leurs proches. Silvana Hernando, Registered Psychotherapist, Rainbow En tant qu’organisme qui fournis ce service unique et éloigné des Health Ontario, Toronto, Ontario grands centres, nous sommes appelés à développer des liens avec différents partenaires afin de bien outiller les individus, les Trans, gender non-conforming, and non-binary BIPOC folks différents milieux, les intervenants et les professionnels ainsi que experience unique, chronic, repetitive and complex forms of la population en général. trauma as they navigate intersectionality. These experiences are Notre présentation reflète comment l’organisme a su répondre often questioned, dismissed, and erased by those who tend to rapidement et en si peu de temps à un besoin dans une région benefit from systemic oppression, including health and helping éloigné; professionals. This dynamic constitutes a significant barrier - Répondre aux besoins d’accueil, de soutient et de références to accessing ethical and responsive health care. As a result, avec divers professionnels intersectional folks internalize their stress reactions, which - Répondre aux besoins des questionnements des individus can manifest as shame, self-doubt, a sense of disconnection vivants avec la diversité de genre with oneself, physical health issues, and a range of other harmful - Répondre aux besoins de formations des intervenants et de psychological, spiritual, and interpersonal consequences. différents milieux, en majorité scolaire. Healing spaces that acknowledge and respond to these realities - Répondre aux besoins de sensibilisation et de formation des are rare, even though the demand for these spaces is différents professionnels en santé et services sociaux, sur les high. This workshop offers critical insights into the ethics of interventions à avoir avec la clientèle de la diversité de genre. advocating for and facilitating safe spaces that appropriately Cette brève description a comme objectif de présenter notre address the daily traumas of racism, colonialism and model d’organisme et nos services afin que d’autres milieux transphobia. This innovative and interactive skills-building peuvent s’en inspirer. workshop provides an opportunity for professionals to learn how Nos panélistes seraient ex : Louise Lacroix, coordonnatrice to facilitate healing spaces for T/GNC/NB BIPOC folks with the et conjointe d’une personne trans (Nicolas Niquette), Maude principles of antiracism/anti-oppression, decolonization, trauma- Bourgeois-Turcotte, psychologue et membre du c.a. , Nicolas informed care and cultural humility. We will draw from practice- Niquette, Fondateur de l’organisme et homme-trans, Sophia and community-based evidence gained through providing Moreau, parent d’un jeunes trans qui a reçu des individual and group psychotherapy for T/GNC/NB BIPOC folks services de l’organisme, et un usager (à déterminer). in Toronto, ON. Participants will be asked to speak to their relationship to systemic discrimination, to reflect on their capacity to stand with marginalized and intersectional communities, and encouraged to collaborate on how to impact health outcomes by working with and for these communities.

26 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

32E. Gender-Based Violence & LGBTQ2+ 52E. Transgender Youth and Suicide: Issues Youth - A National Consultation and Trends (Oral Presentation) (Oral Presentation) Presenter: Presenter: Dr. Kristopher Wells, Associate Professor, MacEwan University, Fae Johnstone, Wisdom2Action, Ottawa, Ontario Edmonton, Alberta

On behalf of the Public Health Agency of Canada, Wisdom2Action, This presentation will (1) share key results from the Canadian a national youth-focused research, evaluation, youth engagement Trans Youth Health Survey; (2) discuss results from research, and knowledge mobilization organization, engaged with which examine the variability of suicide attempts among approximately 550 youth, LGBTQ2+ youth in particular, across transgender youth (i.e., Female to Male, Male-to-Female, Canada to identify the particular ways LGBTQ2+ youth were Non-binary, and questioning); (3) identify protective factors for impacted by Gender-Based Violence (GBV) from January to March transgender and non-binary youth; (4) discuss areas for future 2019. The objectives of this engagement including allowing research; and (5) highlight new Canadian resources in suicide LGBTQ2+ youth to identify their priorities related to addressing and prevention. preventing GBV. Despite a growing emphasis on the particular impact of Gender------Based Violence on LGBTQ2+ communities, little evidence exists that highlights the particular ways in which it does so, nor 3:30 - 3:45 pm Break & EXHIBITS captures the particular needs, priorities and recommendations of LGBTQ2+ youth on Gender-Based Violence. Our consultation 3:45 - 5:15 pm sought to address this gap, with a particular emphasis on the experiences and perspectives of young LGBTQ2+ folks impacted CONCURRENT SESSIONS by different forms of oppression. Through surveys, in-person consultations and online meetings, we engaged youth from coast to coast to get their thoughts. 94E. Gender Constellations: Street harassment, bullying in schools and a lack of public safety A Galaxy of possibilities (Workshop) – especially for gender nonconforming and racialized LGBTQ2+ Presenter: youth, bad experiences with health and social services, anya gwynne, Education Coordinator, PARN Peterborough unwelcoming families, negative media portrayals and sexual AIDS Resource Network, Peterborough, Ontario violence were all too common and all too familiar ways they felt the impacts of Gender-Based Violence. This workshop is a creative and interactive way to look at our own But we wanted to learn more than ‘what’s wrong’, so we asked gender experiences and gain new perspectives in working with our what we could do better. We heard that LGBTQ2+ youth want more clients. Initially this tool was developed as an experiential, education for their peers, their parents and the general public. expressive art exercise to help trans clients talk about the places They want better training for health providers, social service in their lives where they have experiences euphoria or dysphoria providers, teachers, and school officials to make these spaces and around their gender and the conflict of expectations they have services safer for them. They want peer support programs and felt with people in their lives and sometimes themselves. This community spaces created by and for LGBTQ2+ youth, and they learning exercise proved useful to use with other groups as well, want better services to help parents too. More than anything else, especially in helping service providers working with trans and they want action to end LGBTQ2+ youth homelessness, as nonbinary populations to gain greater insight into what is like to those facing homelessness are among the most vulnerable to not be validated in the experience of their identities. We begin with Gender-Based Violence. a guided discussion around gender, in particular the colonized binary approach to gender that is prevalent in western society and how this connects to the social determinants of health. How does our relationship to gender impact our access and experiences with formal and informal approaches to health care? Using a “narrative charting’ technique, participants are encouraged to look at their own lives and plot their experiences of gender, expectations from society, self and others, as well as, attractions on a chart. The approach is meant to allow people to access narrative memory, have ownership of it yet allow distance from the emotional impact of the events. We then create a galaxy of the charted constellations, sharing the journey. We follow with debriefing the

27 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA activity and possible applications for this tool. This workshop and trans* populations, will benefit from learning about this is of most use for those working with trans, non-binary people project. in a therapeutic setting or anyone who creates programming for this population and is particularity helpful in increasing 65E. Increasing Access to Integrated Care understanding around non binary expressions. Since creating for Trans* & Gender-Diverse Youth: this workshop is has been adapted and used by service providers and educators across Canada and abroad. The Development of a Provincial Network of Competent Trans* Health Care Providers 64E. Trans Newcomers Online Resource Hub (Panel) (Panel) Presenters: Dr. Sue Zinck, Dalhousie University/IWK Health Centre, Presenters: Halifax, Nova Scotia Chris Wolff, Vancouver, British Columbia Robert Bartlett, IWK Health Centre, Halifax, Nova Scotia Alex Pershai, Vancouver, British Columbia Nancy Wright, IWK Health Centre, Halifax, Nova Scotia The panel discusses the benefits and difficulties of creating Nova Scotia has a specialized team of child & adolescent mental an online resource that supports trans* newcomers to British health clinicians and an endocrinologist to provide treatment for Columbia and specifically the Greater Vancouver Area. It presents trans* and gender-diverse youth. Based at the largest pediatric the Trans Newcomer Online Resource Hub, a collaborative project teaching hospital that serves the Maritime Provinces, the IWK between Trans Resource Collective and MOSAIC BC, and funded Health Centre’s Trans Health team has provided mental health by Transcare BC. assessment and support since 2006, and its Trans Health MOSAIC is one of the largest settlement organizations in BC Endo team has been offering hormone treatments since 2013. and works with refugees, immigrants and no-status persons. Its clinician leaders also provide education to academic clinician Trans Resource Collective was formed in 2018. TRC is a young trainees of all levels. volunteer initiative that aims to create a support network from As awareness and acceptance of gender-diversity increases, trans immigrants for trans immigrants. In our vision, we want to so does demand for gender exploration and transition support create a welcoming and safe environment for trans newcomers services. With a growing wait-list, the team led the development to Vancouver. We want to make sure that every transgender of an accredited, 2-day, multi-disciplinary education symposium newcomer has full access to trans-friendly housing, medical for health care providers. This initiative has now trained over 170 support, social services and community resources. The collective’s clinicians. These providers were invited to join a monthly, one- mission is to strengthen the transgender community by helping hour-long, tele-and video-conference peer supervision network transgender newcomers and educating social service providers. to discuss all aspects of care. There are now one or more trained Our activities include research about resources providers in every public child & youth community mental available for and about transgender immigrants; conducting focus health clinic in N.S (and many in private practices). Youth groups and interviews with transgender newcomers; incorporating from these mainly rural areas can now receive assessment and trans voices in existing and developing municipal and provincial services in their own communities. One year later, a second policies, as well as developing and facilitating educational group of clinicians taken the training, over 50 have used the workshops for social and government workers. network regularly and care capacity continues to grow. The Collective aims to grow partnerships with health care providers In this workshop, team members will share the elements of in BC, immigration and refugee support services and community the education symposium, the successes and challenges in organizations which are willing to expand their knowledge about building and maintaining a quality, care network. This will include trans issues and living conditions of transgender newcomers. quantitative and qualitative evaluation feedback from clinician The project we are presenting is the first step in this direction. participants and from the pediatric health centre’s central referral The Trans Newcomers Online Resource Hub, launched in March service of this new clinical care path. 2019, aims to provide guidance to trans* immigrants before, This workshop will be of interest to any seeking to begin or to during and after they arrive to Vancouver. We list existing services improve an educational or clinical network of trans-competent that help new trans* immigrants to find medical support, trans* care providers. friendly housing, English courses, social services and peers. Trans newcomers have the opportunity to address questions and concerns they have through email, as well as a blog. In our panel presentation, we will address systemic obstacles and potential ways to work around them. Everyone, especially trans, nonbinary, gender-nonconforming, genderqueer, agender people, as well as trans* activists and service providers who work with immigrants

28 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

89E. Gender Health Care Challenge: 97E. Trans Affirmation in the Workplace: The Board Game (Workshop) Policy and Law (Workshop)

Presenters: Presenters: Dr. Beth Clark, The University of British Columbia, Vancouver, Jade Pichette, Pride at Work Canada, Ottawa, Ontario British Columbia Stephanie Young, Borden Ladner Gervais LLP, Toronto, Ontario Dr. Elizabeth Saewyc, The University of British Columbia, Trans and gender diverse people in Canada experience high rates Vancouver, British Columbia of unemployment and underemployment which has direct effects Gender Health Care Challenge: The Board Game is a knowledge of their overall health and wellness. Many trans and translation tool based on findings from a recent dissertation on gender diverse people will also either not transition or remain youth hormone therapy decision-making. The game was designed stealth at work for fear of losing their employment. Utilizing by trans youth through Trans Youth in Translation, a project aimed the trans-inclusion policies and procedures of Borden Ladner at translating research findings into creative works. The goal was Gervais LLP as a case study, Pride at Work Canada and Borden to design an evidence-based tool to help health care providers Ladner Gervais will discuss the roadmap for best practices for understand what trans youth experience when they attempt to trans inclusion in the workplace. This workshop will discuss the access hormone therapy. This interactive workshop will allow story of how Borden Ladner Gervais, one of Canada’s largest participants to experience the challenges inherent in accessing law firms and named one of Canada’s Best Diversity Employers hormone therapy through board game play with other learners. 2019, navigating creating some of the most inclusive policies and The game incorporates several elements that affect access to procedures for trans employees in Canada. We will address how hormone therapy, including gender, race/ethnicity, geographic to build organizational buy-in for a trans inclusion strategy, and location, proximity to a clinic with gender health care services, discuss very explicitly the legal case of why trans inclusion policies family support, and mental health. and procedures are needed, and how to develop them. We will Playing cards describe experiences documented through showcase examples of best practices, and engage participants to interviews with trans youth, and three levels within the game discuss how this relates to their own workplace. (discovery, interaction, reflection) are based on a theoretical model illustrating trans youth hormone therapy decision-making processes. Background about the larger research project, the theoretical model, and the arts-based knowledge translation project will be presented. Learners will have an opportunity to reflect on their board game experiences and how these learnings could be used to support evidence-informed gender- affirming practices in their organizations. Participants will also be invited to provide feedback as part of a study evaluating the effectiveness of this tool for enhancing health care provider education about youth gender health care. Learning objectives include: increasing understanding of the experiences of Canadian trans and non-binary youth who are making decisions about, and attempting to access, hormone therapy; gaining insight into the psychosocial experiences of youth attempting to access care through first person interactive game play and group discussion; and identifying evidence-informed ways to improve practices in organizations providing care for trans and non-binary youth.

29 CPATHCPATH CONFERENCE CONFERENCE 2019 2019 - -ADVANCING ADVANCING TRANS TRANS HEALTH HEALTH AND AND WELL-BEING WELL-BEING IN IN CANADA CANADA

Youth97E. andTrans Families Affirmation / Jeunes in the et famillesWorkplace: 29E.Youth Navigating and Families Un(familiar) / Jeunes Terrain: et familles Policy and Law (Workshop) Experiences of Adolescent Siblings of 10F. Parents d’enfant trans ou 10F. Parents d’enfant trans ou Transgender Youth (Oral Presentation) Presenter:non-binaires : entre besoins et services, non-binaires : entre besoins et services, Jade Pichette, Pride at Work Canada, Ottawa, Ontario un fossé à combler ? (Présentation orale) Presenters: un fossé à combler ? (Présentation orale) Co-presenter: Eli Godwin, MEd, Boston Children’s Hospital, Boston, Presenter: Presenter:Stephanie Young, Borden Ladner Gervais LLP, Toronto, Massachusetts Natasha Dionne, travailleuse sociale et psychothérapeute, NatashaOntario Dionne, travailleuse sociale et psychothérapeute, L.B. Moore, MEd, Boston Children’s Hospital; Boston GLASS, Montreal, Quebec Montreal, Quebec Trans and gender diverse people in Canada experience high Boston, Massachusetts Dans des contextes sociaux souvent hostiles, les parents qui ont Dansrates des of unemployment contextes sociaux and souvent underemployment hostiles, les whichparents has qui direct ont While recent research has begun to address the effects of family des enfants trans ou non-binaires doivent prendre des décisions deseffects enfants of their trans overall ou non-binaires health and doiventwellness. prendre Many transdes décisions and support on transgender and gender nonconforming (TG pour eux·elles concernant leur transition personnelle, sociale, pourgender eux·elles diverse concernant people will leur also transition either not personnelle, transition or sociale, remain N) youth, few studies have examined the effects of the TGN légale et médicale. En plus d’être eux·elles aussi à risque de légalestealth et atmédicale. work for Enfear plus of losing d’être their eux·elles employment. aussi à risque Utilizing de youth’s transition process on the family system as a whole. subir de la stigmatisation et de l’isolement, ces parents craignent subirthe trans-inclusionde la stigmatisation policies et deand l’isolement, procedures ces of parentsBorden craignentLadner The scant literature that has included siblings of TGN people que leurs enfants soient marginalisés·es ou qu’ils·elles subissent queGervais leurs LLP enfants as a soientcase study, marginalisés·es Pride at Work ou qu’ils·elles Canada and subissent Borden nearly universally includes only adult siblings positioned as as de la violence. Pourtant, peu de professionnels·les de la santé et deLadner la violence. Gervais Pourtant, will discuss peu thede professionnels·lesroadmap for best practicesde la santé for et controls. To date, no peerreviewed studies have directly queried des services sociaux du réseau public québécois sont formés·es destrans services inclusion sociaux in the du workplace. réseau public This québécoisworkshop willsont discuss formés·es the adolescent siblings of TGN youth about their own experiences ou sensibilisés·es aux besoins spécifiques des personnes trans oustory sensibilisés·es of how Borden aux Ladnerbesoins Gervais, spécifiques one ofdes Canada’s personnes largest trans and support needs. et de leur entourage. Ma recherche s’intéresse à la signification etlaw de firmsleur entourage. and named Ma one recherche of Canada’s s’intéresse Best Diversity à la signification Employers As part of the Trans Teen and Family Narratives Project, a que ces parents élaborent au sujet de la différence de leur que2019, ces navigating parents élaborent creating ausome sujet of dethe la most différence inclusive de policiesleur community-based sample of 33 families (33 TGN youth ages 13- enfant et à celle prévalent dans les services sociaux et de santé enfantand procedures et à celle prévalent for trans dansemployees les services in Canada. sociaux We et will de address santé 17 years, 48 caregivers, and 15 siblings ages 13+) was recruited publics, privés et communautaires. Elle explore également leur publics,how to buildprivés organizational et communautaires. buy-in forElle a explore trans inclusion également strategy, leur from the New England region of the United States. Participants trajectoire dans les services sociaux et de santé, en identifiant trajectoireand discuss dans very les explicitly services thesociaux legal etcase de santé,of why entrans identifiant inclusion completed in-person qualitative interviews and surveys at five les ressources auxquelles ils·elles ont eu recours et en analysant lespolicies ressources and procedures auxquelles areils·elles needed, ont euand recours how to et develop en analysant them. waves in 6-month intervals. Interviews were audio-recorded les répercussions de ces services dans leur vie et dans lesWe répercussions will showcase de examples ces services of best dans practices, leur vie andet dans engage and professionally transcribed. For the current study, 15 l’accompagnement de leur enfant trans ou non-binaires. l’accompagnementparticipants to discuss de leur how enfant this relates trans outo theirnon-binaires. own workplace. sibling interview transcripts from baseline were analyzed using immersion/crystallization and thematic analysis. Analyses29E. Navigatingyielded three prominent Un(familiar) themes: familiarityTerrain: with, awarenessExperiences of, and knowledge of Adolescent about transness Siblings (“FAKTs”) of as The mediatorsTransgender of sibling responses; Youth assessing (Oral Presentation) responses of others to Canadian their TGN sibling (“relational terrain”), and experiences unique to Psychological siblingsPresenter: of TGN youth. Within these themes, multiple subthemes Association is a wereEli Godwin, also identified; MEd, Boston for example, Children’s siblings Hospital, assessed Boston, responses proud supporter of to theMassachusetts TGN sibling with respect to their own social standing the transgender (“courtesyCo-presenter: stigma”) and the social, emotional, and physical well- community through beingL.B. ofMoore, their sibling.MEd, Boston Children’s Hospital; Boston GLASS, our Advocacy work Our findingsBoston, Massachusettsindicate the need to engage with siblings of TGN youth directly to further elucidate their intra-familial, and Sexual Orientation While recent research has begun to address the effects of extra-familial, and intrapersonal experiences related to their and Gender Identity family support on transgender and gender nonconforming TGN sibling and determine their unique support needs. We Section (SOGII) (TGN) youth, few studies have examined the effects of the TGN will discuss further implications for families, clinicians, and youth’s transition process on the family system as a whole. researchers and present a narrative illustration for potential The scant literature that has included siblings of TGN people use by clinicians and others who work with or support this To learn more about CPA nearly universally includes only adult siblings positioned as as population. cpa.ca controls. To date, no peerreviewed studies have directly queried adolescent siblings of TGN youth about their own experiences To join the CPA and SOGII section sogii.ca and support needs. As part of the Trans Teen and Family Narratives Project, a community-based sample of 33 families (33 TGN youth ages 13- 17 years, 48 caregivers, and 15 siblings ages 13+) was recruited Advocacy • Knowledge Advancement • Research • Resources • Conference from the New England region of the United States. Participants completed in-person qualitative interviews and surveys at five waves in 6-month intervals. Interviews were audio-recorded

2930 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

47E. Groups for Parents of Trans Primary Care and Trans Health and Gender Exploring Youth Soins de santé primaires en santé trans Using a Systemic Lens (Oral Presentation)

Presenters: 36E. Type of Health Care Contact Dr. Marjorie Rabiau, PhD, Assistant Professor, McGill (face to face versus telemedicine) University, Montreal, Quebec as a Predictor for Appointment Attendance Maude Desrochers, Sexologue, McGill University, Montreal, Status at the Centre for Addiction and Quebec Mental Health (CAMH) Gender Identity Mayte Parada, Couple and Family Therapist, McGill Clinic (Oral Presentation) University, Montreal, Quebec Presenter: The objectives are to present the implementation of a pilot group June Lam, CAMH, Gender Identity Clinic, Psychiatry Resident for parents of Trans and gender exploring adolescents. The group Physician, Toronto, Ontario was facilitated by couple and family therapists, and used a specific lens of addressing couple and family dynamics. The Introduction: A cross-sectional study in Ontario (the Trans objective of the group was to support families towards an PULSE study) found 43% of trans Ontarians attempted suicide affirmative care model with their youth by offering a space in their lifetime compared to 3.5% of the general Canadian for learning about and deconstructing prior assumptions population. about gender. The group included psycho-education as well Access to medical transition, including transition-related as discussions on the how to address differences of opinions surgeries, is associated with decreased suicidality, suggesting between parents, involving sibling and extended family members, that minimizing wait time to access transition-related surgeries and advocating with the broader social network. The therapeutic may reduce suicide. Since trans patients travel from all across lens for the groups was primarily systemic with the family system the province to go to CAMH (the Centre for Addiction and as the core construct as well as the socioecological context Mental Health) for assessments to support access to transition- (Bronfenbrenner). The main philosophy of the group was related surgeries, attendance for an in-person appointment collaborative and participatory in order for participants to feel can be challenging. Appointments via confidential video empowered in the process. We would like to discuss lessons and teleconferenceing or other technology (i.e. telemedicine or obstacles encountered during the implementation of this pilot telepsychiatry) may be a solution that improves attendance and group and interact with the audience on ways to optimize our access to care for trans patients. service delivery. Methods: Anonymized data were collected for every patient who attended the CAMH Gender Identity Clinic from April 1, 2015 to March 30, 2018. Descriptive statistics were performed to compare patients who were scheduled for a face to face appointment versus those scheduled for a telemedicine appointment. Multivariable logistic regression was used to assess for any association between type of clinic contact (face to face versus telemedicine) and attendance status (attended the appointment versus not) after adjusting for covariates. Results: There were 1277 individual patients with clinic data available. Telemedicine appointments were statistically significantly better attended (97.30% versus 71.66%, p<0.0001) and shorter in duration (mean 18.76 minutes versus 64.26 minutes, p<0.0001) compared to face to face appointments. Multivariable logistic regression found that telemedicine appointments were significantly associated with higher attendance (OR 58.8, 95% 95% CI 7.8 - 446.5, p<0.0001) even after adjusting for demographic (age, race, region of residence) and clinic appointment (duration of appointment, number of previously scheduled appointments) factors. Conclusion: Telemedicine is associated with significantly higher attendance rates at the CAMH Gender Identity Clinic, which improves access to transition-related surgeries and can reduce suicidality as a result. The results suggest that more resources

31 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA to support telemedicine as an option for trans patients may be indicated both at the CAMH Gender Identity Clinic and at other sites providing similar care.

54E. “Primary care is primary care”: Use of Normalization Process Theory to Explore the Implementation of Primary Care Services for Transgender Individuals in Ontario (Oral Presentation)

Presenter: Erin Ziegler, PhD(C), Nurse Practitioner, Toronto, Ontario

Background: In Ontario, Canada, healthcare for transgender individuals is accessed through primary care; however, there are a limited number of practitioners providing transgender care, and patients are often on waiting lists and/or traveling great distances to receive care. Understanding how primary care is implemented and delivered to transgender individuals is key to improving access and eliminating healthcare barriers. The purpose of this study is to understand how the implementation of primary care services for transgender individuals compares across various models of primary care delivery in Ontario. Methods: A qualitative, exploratory, multiple-case study guided by Normalization Process Theory (NPT) was used to compare transgender care delivery and implementation across three primary care models. Three cases known to provide transgender primary care and represent different primary care models in Ontario, Canada (i.e., family health team, community health centre, fee-for service physician) were explored. The NoMAD survey, a tool to measure implementation processes, and qualitative interviews with primary care practitioners and allied healthcare staff were administered. Results: Using the NPT framework to guide analysis, key themes emerged about implementation of primary care services for transgender individuals. These themes include creating a safe space for patients, identifying gaps in services, understanding practitioners’ roles, and the need for more training and education in transgender care for practitioners. Conclusions: Primary care services for transgender individuals can and should be delivered in all models of primary care. Training and awareness for healthcare practitioners are needed to develop capacity in providing primary care to transgender individuals. A greater number of practitioners and organizations are needed to take on this work, embedding and normalizing transgender care into routine practice to address barriers to access and improve quality of care for transgender individuals. ______

End of Day - Free time

32 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

CPATH 2019 Conference Program

Saturday, November 2 / samedi 2 novembre, 2019

All Day Registration / Inscription Dr. Annie Pullen Sansfaçon

is a Full Professor of Social Work at the 7:30 - 8:30 am Breakfast University of Montreal. Since 2010, she has 7:30 - 8:30 am Caucus Opportunities focused much of her research time on various

projects aimed at better understanding the 9:00 - 10:30 am PLENARY (EN) experience of trans youth and their families. (service de traduction simultanée au besoin) She has published several book chapters and Moderator: Ace Chan articles on the experience of trans youth and their families, as well as on trans-affirming Dr. Annie Pullen Sansfaçon Dr. Jake Pyne practices, stressing the importance of social changes in order to Dr. Elizabeth Saewyc ensure trans youth well-being. She is the co-author of the book Tatiana Ferguson “Supporting Trans and Gender Creative Youth: Schools, Families, and Communities in Action” (Peter Lang, 2014 and revised edition in Research with Trans, Non-Binary, and 2018) and is one of the co-founders of Gender Creative Kids Canada, Gender Creative Children and Youth a Montreal-based community organization working with trans children This panel looks at emerging research around trans youth experi- and youth and their families. She is also a research at the Research ence in Canada. It will begin by three short presentations looking at Institute for Public Health of the University of Montreal, and an Associate emerging data from projects currently underway, paying particular Researcher at the School of Social Work of the University of Stellenbosh, attention to intersectional analysis, and to how social locations in South Africa. shape different types of experiences. Then, the presentations will Dr. Jake Pyne is a Banting Postdoctoral Fellow be discussed by a respondent with key professional and community at Re.Vision: The Centre for Art and Social perspectives. The presentation will conclude by an open discussion. Justice at the University of Guelph. Over the Moderator: past 18 years, Jake has worked on a range of Ace Chan is a community-based public health researcher with an research and advocacy projects in Toronto’s interest in cancer prevention and decreasing health disparities in trans community, including efforts to create sexual and gender minority communities. access to emergency shelter and anti-violence Speakers: services, access to health care and family law Tatiana Ferguson is a Project Coordinator and justice, and efforts to build support for gender Sexual Health Educator. Since her arrival to independent kids and trans youth. Jake’s recent doctoral study focused Canada from the Bahamas in 2014, she has on this current generation of trans youth and posed questions about how been very active advocating for the inclusion of their futures have become thinkable in this time and place. His current Trans people and people of color in community postdoctoral research focuses on the intersection of autistic and trans programs and services. Her work is informed by life. In 2020, Jake will take up a position as an Assistant Professor in the an anti-oppression framework and incorporates School of Social Work at York University. an intersectional approach which considers Dr. Elizabeth Saewyc PHD, RN, FSAHM, how various aspects of one’s identity can inhibit FCAHS, FAAN, iis Professor and the Director of equitable access to programs and services. Currently, she is working the School of Nursing at the University of British on the TransFormed project; a community-based research and Columbia in Vancouver, Canada; she also leads intervention project at METRAC: Action on Violence to address Partner the multidisciplinary Stigma and Resilience Violence from Two-Spirit, Nonbinary and Trans peoples perspectives. Among Vulnerable Youth Centre. For more than She is also a founding member of the Black Queer Youth Collective 20 years, Dr. Saewyc’s research and clinical (BQYC); a grassroots group dedicated to serving Black Queer and practice as a public health nurse has focused on Trans youth in Toronto. The BQYC utilizes peer-led approaches to health equity for marginalized youth, especially develop and facilitate culturally relevant programs to support Black for lesbian, gay, bisexual, transgender, queer, and Two Spirit (LGBTQ2S) LGBTQ+ youth under 29 yrs old. As a Black trans woman, her lived adolescents. Her research and public health nursing practice has experience has fuelled her passion and drive to create alternative focused on how stigma, violence, and trauma influence adolescents’ models of support and inform best practices for system change so health and coping behaviours, and what protective factors can foster that underserved groups have access to a better quality of life. resilience and improve health equity for marginalized young people, 33 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA especially LGBTQ youth, homeless, runaway and street-involved faciliter des programmes adaptés à la culture des jeunes LGBTQ+ adolescents, sexually abused/exploited teens, immigrants and noirs âgés de moins de 29 ans. En tant que femme transgenre refugees, and Indigenous young people in several countries. She was noire, son expérience de vie a renforcé sa passion et sa volonté lead investigator for the first federally funded Canadian Trans Youth de créer des modèles alternatifs de soutien et d’informer les Health Survey in 2013- 2014, and has just launched the repeat meilleures pratiques pour changer le système afin que les groupes survey 5 years later. She is a Fellow in the Society for Adolescent désavantagés aient accès à une meilleure qualité de vie. Health and Medicine, in the Canadian Academy of Health Sciences, Dr. Annie Pullen Sansfaçon Kwe! Annie and in the American Academy of Nursing. Pullen Sansfacon yiatsih. Wendat endi’. Je suis détentrice d’un Ph.D en éthique et travail 9h00 - 10h30 am PLÉNIÈRE (EN) social (De Montfort University, UK, 2007) et je (Simultanious Translation) m’intéresse aux approches anti-oppressives et Moderator: Ace Chan à l’éthique depuis le tout debut de ma carrière. À partir de ces thèmes, j’ai développé un axe Dr. Annie Pullen Sansfaçon Dr. Jake Pyne de recherche visant à mieux comprendre les Dr. Elizabeth Saewyc expériences d’oppression et de résistance des enfants et des jeunes trans et leurs familles et je travaille au Tatiana Ferguson développement des meilleures pratiques pour les soutenir. Je suis Recherche avec trans, non-binary impliquées dans plusieurs projets de recherche tant au niveau et genre créatif enfants et Jeunes national qu’international, et je suis cofondatrice de l’Organisme Enfants transgenres Canada. Finalement, je suis chercheuse Ce panel examinera les recherches émergentes sur les associée à l’École de travail social de l’Université Stellenbosch en expériences des jeunes transgenres au Canada. Il débutera Afrique du Sud. par trois courtes présentations portant sur les données émergentes des projets en cours, en accordant une attention Dr. Jake Pyne est boursier postdoctoral Banting particulière à l’analyse intersectionnelle et à la façon dont les lieux chez Re.Vision : Le Centre for Art and Social sociaux encadrent des différents types d’expériences. Une jeune Justice de l’Université de Guelph. Au cours personne trans répondra ensuite aux présentations dans la voie de des 18 dernières années, Jake a travaillé sur ses propres expériences. La présentation se terminera avec une variété de projets de recherche et de discussion ouverte. plaidoyer au sein de la communauté transgenre de Toronto, y compris : des efforts pour créer Modérateur: l’accès à des refuges d’urgence, à des services Ace Chan is a community-based public health researcher with an antiviolences, aux soins de santé et à la justice interest in cancer prevention and decreasing health disparities in familiale. Il a également fait des contributions pour renforcer le sexual and gender minority communities. soutien aux enfants et jeunes transgenres indépendants. Dans Conférenciers : son étude doctorale récente, Jake s’est intéressé à la génération Tatiana Ferguson est coordonatrice de projet présente de jeunes transgenres et s’est demandé comment leur et éducatrice en santé sexuelle. Depuis avenir est bien pensable à cette époque et dans ce lieu. Ses son arrivée au Canada en provenance des recherches postdoctorales en cours portent sur l’intersection de Bahamas en 2014, elle milite activement l’autisme et de la vie transgenre. En 2020, Jake occupera un poste en faveur de l’inclusion des personnes de professeur adjoint à l’École de service social de l’Université York. transgenres et de couleur dans les Dr. Elizabeth Saewyc Ph.D., IA, FSAHM, programmes et services communautaires. FCAHS, FAAN, est professeure et directrice de Son travail s’inspire d’un cadre antioppression l’École des sciences infirmières de l’Université et intègre une approche intersectionnelle qui de la Colombie-Britannique à Vancouver, examine comment divers aspects de l’identité d’une personne Canada. Elle dirige également le centre peuvent nuire à un accès équitable aux programmes et services. multidisciplinaire Stigma and Resilience Among Elle travaille présentement sur le projet TransFormed : un projet Vulnerable Youth Centre. Depuis plus de 20 ans, de recherche et d’intervention communautaire Action on Violence la recherche et la pratique clinique de la Dre à METRAC qui aborde la question de la violence entre partenaires Saewyc en tant qu’infirmière en santé publique du point de vue des personnes deux esprits, non binaires et sont axées sur l’équité en santé pour les jeunes marginalisés, en trans. Elle est également membre fondatrice du Black Queer particulier les adolescents lesbiennes, gais, bisexuels, transgenres, Youth Collective (BQYC), un groupe communautaire au service queer et bispirituels (LGBTQ2S). Sa recherche et sa pratique des des jeunes Queers noirs et transgenres à Toronto. Le BQYC soins infirmiers en santé publique ont porté sur la façon dont la utilise des approches dirigées par des pairs pour élaborer et stigmatisation, la violence et les traumatismes influencent la santé

34 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA des adolescents et leurs comportements d’adaptation. De plus, sa Learning Objectives: recherche vise à évaluer les facteurs de Participants will learn about operating a peer led trans program, protection qui peuvent favoriser la résilience et améliorer l’équité and creating space for people with lived experience. en santé des jeunes marginalisés, particulièrement : les jeunes Participants will learn about ways to work with rural, remote, and LGBTQ, les sans-abris, les jeunes fugueurs, les adolescents de la northern communities. rue, les adolescents victimes de violence sexuelle, les immigrants Participants will learn how to create programming that meets the et réfugiés, les jeunes Autochtones de divers pays. Elle a été la cultural and linguistic needs of their communities and using an chercheuse principale de la première Sondage sur la santé des intersectional approach to service delivery. jeunes transgenres canadiens financé par le gouvernement fédéral en 2013- 2014, et elle vient tout juste de lancer le nouveau sondage 28E. Creating and Improving Trans Affirming cinq ans plus tard. Elle est membre de la Society for Adolescent Health Resources in Waterloo Region: Health and Medicine, de l’Académie canadienne des sciences de la A Community-Initiated Mobilization Project santé et de l’American Academy of Nursing. ______(Oral Presentation) Presenters: 11:00 am - 12:30 pm Ashley Flanagan, University of Waterloo, Waterloo, Ontario CONCURRENT SESSIONS Dr. Corey Johnson, University of Waterloo, Waterloo, Ontario Previous research on the health of transgender (trans) individuals Community Approaches to Trans Health who live in Canada has revealed that members of the trans Approches communautaires en santé trans community are consistently underserved in both primary and emergency health care settings—citing barriers such as lacking knowledgeable care providers, refusal of access to health care, 19E. Trans Peers as Agents of Change in and/or care provider refusal to approve hormone therapy and/or Northern Ontario (Oral Presentation) surgeries (Bauer, Hammond, Travers, Kaay, Hohenadel, & Boyce, 2009; Bauer, Scheim, Deutsch, & Massarella, 2014; Woodford, Presenter: Coulombe, Marshall, Schwabe, Krensni, & the Canadian Centre Vincent Bolt, Education Manager, TG Innerselves, Sudbury, for Gender and Sexual Diversity, 2019). In recognition of the Ontario health disparities faced by trans Canadians, the Canadian Medical Innerselves was founded by trans community members in Association (2015) has called for accessible, comprehensive, Sudbury Ontario with the needs of northern Ontario in mind. Our and high-quality care for transgender patients. However, our catchment area spans from Muskoka, to the southern shores of recent work with trans individuals who live in Waterloo Region James Bay in the north, and from White River in the west, and has demonstrated the need for continued efforts to improve the east to the Quebec boarder. There are some unique challenges quality and availability of trans affirming care within our region when you service an area that spans 280,290.16 km2 with with For example, The Outlook Study highlighted that when accessing a population of 505,625. The cities, towns, and communities or attempting to access hospital/emergency care services, trans are spread out, with limited infrastructure in between. We work respondents reported that 23% of care providers used hurtful or in a catchment area with many Indigenous communities, and insulting language about trans identity/experience, 20% refused to francophone people. This is why our work includes Indigenous discuss/address trans-related health concerns; 25% told patient programming, and services in both French and English. This they don’t know enough about trans-related care to provide presentation will cover how this community-based peer run it; and 3% refused to provide care (Coulombe & Woodford, program was developed, and how we provide programs to 2018). Therefore, rooted in community concern and collective our catchment area that includes urban, rural, and northern memory work methodology (Haug, 1992; Johnson, 2018), the communities. This presentation will cover the why TG Innerselves principal investigators – along with a committee of community started, and how we chose our current catchment area, the stakeholders – organized the inaugural Transgender Health and ways we have integrated peer led programming, the inclusion of Wellness Conference in Waterloo Region for a small number Indigenous programming, and navigating the diverse needs in of local practitioners, educators, and students in health and such a large area. wellness disciplines. This presentation highlights the triumphs and challenges of attempting to accelerate processes of social change – through knowledge mobilization, transdisciplinary dialogue, and formal trans-specific education – towards a culture of trans affirming, comprehensive, and quality care and education within the Waterloo Region.

35 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

55E. How Does Access and Cost of Trans Health in Rural Context Gender-Affirming Surgery Differ for La santé trans en contexte rural Adolescents and Adults Across Canada? 18E. Overcoming Barriers to Trans Health (Oral Presentation) in Rural Ontario (Oral Presentation) Presenters: Presenter: Dr. Zachary Zytner, Postgraduate Year 3 Pediatric Resident, Nolan Blodgett, Church Wellesley Counselling & Northern Ontario School of Medicine, Sudbury, Ontario and Psychotherapy, Toronto, Ontario Children’s Hospital of Eastern Ontario, Ottawa, Ontario Co-Author: This presentation will explore the numerous barriers to accessing Dr. Margaret Lawson, Pediatric Endocrinologist, Co-Director health care facing trans and gender diverse folks living in rural, of Diversity Clinic, Children’s Hospital of Eastern Ontario, remote, and northern communities across Canada. I will draw Ottawa, Ontario, Professor of Pediatrics, University of on evidence from my recent publication, Overcoming the Barriers Ottawa, Ottawa, Ontario in Transgender Healthcare in Rural Ontario: Discourses of Personal Agency, Resilience, and Empowerment, an exploratory qualitative How does access and cost of gender-affirming surgery differ for study which captured the lived experiences of trans and non-binary adolescents and adults across Canada folks in navigating the health care system. Drawing on practice- Zytner Z1,2, Cheung K1, Khatchadourian K1,3, Tang K3, Lawson based knowledge and learnings gleaned from experience providing ML1,3. psychotherapy and group-based psychosocial support to trans folks Children’s Hospital of Eastern Ontario1, Northern Ontario School in both rural, suburban, and urban settings in Ontario, I will unpack of Medicine2, Children’s Hospital of Eastern Ontario Research the barriers and gaps as well as the strengths that can be leveraged Institute3 in rural trans communities to promote greater inclusion and Introduction: Gender dysphoria is defined as distress caused by improved health outcomes. This presentation will challenge the an incongruence between a person’s gender identity and gender audience to engage in personal and professional reflexivity and assigned at birth. Gender-affirming treatment to alleviate gender identify areas in their own practice for the integration of enhanced dysphoria may include gender-affirming surgery. To ensure cultural humility and inclusion of trans and gender diverse folks equitable and timely access to care, it is essential to understand if living at the intersection of gender diversity and rural communities. barriers to surgical care exist. We hypothesize that conditions and cost of gender-affirming surgery may vary significantly within and between the provinces and territories of Canada. Some 23E. Rural Trans Experiences: individuals may accrue significant personal expense ranging from A Mixed-Methods Community-Based transportation cost to direct costs for surgery. Data regarding Participatory Research Study Into access and cost of gender-affirming surgery are needed so Two Spirit and Trans Health Care individuals can have the information they need to make decisions Experiences in North Simcoe Muskoka about their health. (NSM) (Oral Presentation) Objective: The primary objective is to describe wait times, personal cost and criteria for genderaffirming surgery within and between Presenters: provinces and territories. Ligaya Byrch, MSW, RSW, Community Innovator, Orillia, Methods: A cross-sectional survey has been developed with Ontario appropriately focused and relevant questions in consultation with a Gavrel Feldman, Community Activist, Organizer, methodologist at our Clinical Research Unit. It has been approved Trans Liberation Now, Orillia, Ontario by the Research Ethics Board. The survey will be distributed In late 2017, a mixed-methods study was conducted by local NSM electronically to physicians, surgeons and nurse practitioners researchers (trans and cis) with 4 focus groups (N=21) and an across Canada who may care for transgender and non-binary online survey (N=57). This presentation will explore the specific youth and adults. The survey has been approved by nine Canadian health care experiences of rural Two Spirit and Trans People, medical specialty associations for distribution to its members. The covering topics such as primary health care experiences, identity primary outcomes, including wait times, personal cost and criteria complexities, avoidance of needed health care and employment, for surgery, will be analyzed and compared between provinces, education and income realities. Finally, we will offer a sample territories and types of practitioner. Descriptive statistics will be of recommendations derived from data synthesis and direct used for data analysis. quotations.This study demonstrates where there are overlaps Results: The survey will be completed by June 30, 2019, allowing with urban and rural Ontario Two Spirit and/ or Trans Health care sufficient time for analysis so that results can be presented at experience and where there are differences. A better understanding CPATH 2019. of the specific health care experience of rural trans people is needed in order to improve health outcomes of trans people overall. 36 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

33E. Serving Trans Folks Living in Rural suggests these barriers are further exacerbated for trans/GNC Communities (Oral Presentation) people living in rural communities. Rural trans and GNC clients may be confronted by smaller numbers of primary care practitioners to Presenters: choose from, limited trans-health knowledge and expertise among Alex Karn, Education and Support Worker, Gender Journeys these practitioners, geographical isolation from specialized trans- program, Canadian Mental Health Association, health services, and an increased chance of care delivery within Haliburton, Kawartha, Pine Ridge, Peterborough, Ontario socially and religiously conservative environments that may not be anya gwynne, Education Coordinator, Rainbow Youth, PARN, trans-supportive. Despite these additional challenges, there has Peterborough, Ontario been little previous research that explores the unique experiences of Ále Suárez, Education and Support Worker, Gender Journeys rural trans people with accessing primary care services. Supported program, Canadian Mental Health Association, by an advisory group of rural trans and GNC persons in Southern Haliburton, Kawartha, Pine Ridge, Peterborough, Ontario Alberta, the research team will present the findings of a qualitative research project describing this population’s experience with rural Serving trans folks and their loved ones living in rural communities primary care services. In addition to sharing the research findings, can pose unique challenges. Barriers to service may include recommendations will be made to support the facilitation of increased isolation, geographical distance, lack of access, negative inclusive, high-quality primary care services in a rural context. attitudes and stigmas, as well as clients’ fears of being outed in their social and professional circles. The oral presentation will cover ______information about these unique challenges, as well as possible ways to address them in order to ensure that trans folks and their 113E. FSU: Confronting Norms of Identity & loved ones are able to access the support and education they Gender through Performance (Workshop) need. For example, when possible traveling to meet with clients can improve access to service for those not living in an urban centre. Presenters: Engaging more broadly with the community, providing training to Caitlin Chee, Artist, Toronto, Ontario local service organizations, and raising awareness of trans identities Kaleb Robertson, Artist, Toronto, Ontario can improve local attitudes and create a more supportive overall Drawing from the lived experiences of trans artists Kaleb environment. Ensuring that clients’ privacy and confidentiality are Robertson and Caitlin Chee, this workshop will look at the ways respected can make them feel safer when accessing service. Also, in which performance can act as a site of political resistance and offering programming like community events and support groups for cultural change. Through drag, burlesque, and dance, trans and trans folks in the rural communities where they live can non-binary performers use gender as both a fixed and fluid tool to help them to form supportive relationships with other people of portray identity from a different standpoint than the dominant lens shared experience in their local area. of cis- and hetero-normativity. An essential part of this is ensuring that the full diversity of the community is represented, highlighting 34E. TRANS-forming Rural Primary Care: BIPOC folks and bodies that are often not included in mainstream Exploring the Inclusivity and Safety portrayals of trans and non binary communities. By giving voice to of Rural Primary Care Spaces trans and non binary performers we can foster space for the larger for Trans-people in Southern Alberta trans non-binary community to see themselves reflected through (Oral Presentation) art, and to challenge the normative discourse of how identity and gender should be portrayed. Presenters: We will speak about our lived experiences, and our journey to Peter Kellett, Assistant Professor, Faculty of Health Sciences, creating Toronto’s only all trans and non-binary monthly cabaret. University of Lethbridge, Lethbridge, Alberta We will also look at other trans and non binary artists working to Dr. Jillian Demontigny, Family Physician, The Taber Clinic, confront the cis-normative dominant discourse, and existing Taber, Alberta academic research relating to this work. We will touch upon Judith Co-Authors: Butler’s discussions of the “exclusionary matrix” in Bodies That Lisa Howard, Assistant Professor, Faculty of Health Sciences, Matter (Butler, 1993), Michel Foucault’s queer theory (Roach, University of Lethbridge, Lethbridge, Alberta 2012), and critiques of the gendered dynamics of drag (Rupp, Julia Brassolotto, Assistant Professor, Faculty of Health Taylor, & Shapiro, 2010). Sciences, University of Lethbridge, Lethbridge, Alberta References Jaisie Walker, MA Student, Women & Gender Studies, Butler, J. (1993). Bodies That Matter: On the Discursive Limits of “Sex”. London: Routledge. University of Lethbridge, Lethbridge, Alberta Roach, T. (2012). Friendship as a Way of Life: Foucault, AIDS, and the Politics of Shared Estrangement. Buffalo: SUNY. It is well-documented that transgender and gender non-conforming Rupp, L. J., Taylor, V., & Shapiro, E. I. (2010). Drag Queens and Drag (GNC) people experience numerous challenges to accessing safe Kings: The Difference Gender Makes. Sexualities, 13(3), 275-294. and appropriate health care services, and anecdotal evidence 37 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

95E. Demystifying Trans Health Education: years. If you teach trans health to medical students or residents, How Do We Help Our Learners with expect to share “best practices” so that your learners can be confident and thrive in providing effective trans affirmative TGNC Health Issues? (Workshop) health care. Presenters: Dr. Ted Jablonski MD CCFP FCFP Associate, Crowfoot 106E. Reporting on and Seeking Input Village Family Practice Medical Lead, Calgary Foothills, on A Participatory Action Approach for PCN Clinical Assistant Professor, University of Calgary, Developing Gender Variant-Appropriate Department of Family Medicine Clinical Associate, Clinical Nutrition Practice Guidelines (Panel) Men’s Sexual Health Clinic, Southern Alberta Institute of Urology, Medical Director, Jablonski Health and Skipping Presenters: Stone Foundation. Calgary, Alberta Catherine Morley, Associate Professor, School of Nutrition and Dr. Joe Raiche, MD FRCPC DABPN, Foothills Medical Centre, Dietetics, Acadia University, Wolfville, Nova Scotia Calgary, Alberta Sfé R. Monster, Comic artist/queer activist, Beyond Press, Dr. James R. M. Owen MD CCFP, Assistant Professor, Halifax, Nova Scotia University of Toronto Staff Physician, St Michael’s Hospital Heather Bonnell, Dietetic Practicum Student, School of Inner City Health Program, Department of Family and Nutrition and Dietetics, Acadia University, Wolfville, Community Medicine Course Director, Complexity and Nova Scotia Chronicity, University of Toronto MD Program LGBTQ2S Lindsay Goodridge, MPH Nutrition student, University of Health, Theme Lead, University of Toronto MD Program, Toronto, Toronto, Ontario Toronto, Ontario Nutrition assessment, the process of determining nutritional Dr. Thea Weisdorf MD FCFP ABAM, St. Michael’s Hospital requirements involves estimating nutrient needs (e.g. energy, Toronto, University of Toronto, Toronto, Ontario protein, vitamins/minerals) using ‘male’ and ‘female’-based Dr. Raymond Fung MD FRCPC, Endocrinology and standards. Nutrition counselling incorporates consideration of Metabolism, Internal Medicine, Toronto East General psychosocial aspects of eating. We are interested in developing Hospital, Toronto, Ontario standards for GV people. As there is no extant literature on nutrition Dr. Amy Bourns MD CCFP, Family Physician, Sherbourne assessment/counselling approaches on this topic, these are some of Health, Toronto, Ontario the questions we are exploring through our research. Dr. Nicole Thompson BScOT, MClSc, MD, UBC Obstetrics and The panel addresses all five conference themes. Gynecology Resident, Vancouver. British, Columbia Format: (The panel will have four short presentations): This highly interactive and educational workshop will explore lessons 1. Introduction: Sfé and Cath will describe how/why they started learned from various teaching settings across Canada involving working on developing clinical nutrition practice guidelines. medical students, family medicine, endocrine and psychiatry Sfé will share how transitioning affected their experiences of residents. body shape, appetite, social experience of eating, and eating Examples will include: behaviours. Cath will describe how she integrated knowledge 1. Delphi Study designed to define baseline characteristics for a gleaned from Sfé on the effects of transitioning on food, nutrition, curriculum for trans health for undergraduate medical education and eating into the Nutrition Assessment course she teaches. in Canada. 2. Information gathering: Sfé will summarize information gathering 2. University of Calgary’s Cumming School of Medicine which undertaken at the 2017 CPATH conference. Heather will incorporated a learning module for Trans gender and Gender summarize partnership with Acadia Pride, developing the Diverse physical exams in 2018 and redesigned the trans health research agenda, and information gathering approaches. and LGBTQ+ curriculum using a flipped classroom strategy. Lindsay will describe the community consultation approach 3. The University of Toronto MD Program which incorporated used for information gathering, and analysis of findings. mandatory trans health content including e-learning, clinicals Heather will describe secondary analysis re: community skills, and in-person lectures across the first two years of the recommendations to enhance nutrition care delivery. medical curriculum. 3. Ongoing development and knowledge mobilization (KM): 4. A pilot study exploring trainees exposure to and experiences Lindsay and Heather will invite attendee participation of trans health eduction at U of T’s family medicine residency contributing feedback to the draft guidelines. Cath will describe program. ongoing guideline refinement and knowledge mobilization 5. The establishment of a unique 6 month enhanced skills program plans. Sfé (and all) will invite attendee feedback. in LGBTQ primary care at U of T’s Dept. of Community and Learning objectives: Family Medicine. Attendees will: 6. Recent changes to the endocrine resident curriculum with increased didactic/ clinical exposure to trans care in the last 2 1. Become aware of progress toward developing GV-appropriate

38 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

nutrition care CPGs (incorporating findings from 2017 CPATH 2:30 - 4:00 pm workshop) 2. Learn how we have approached guideline development using a CONCURRENT SESSIONS collaborative, participatory approach 3. Contribute to further develop the guidelines 90E. Resistance in the Post-Truth Era: 4. Contribute to creating a community of people interested in Counteracting Pseudo-science in enhancing gender variantappropriate nutrition care and research. Gender-Affirming Health Care Practice and Research (Workshop) 6F. Vie amoureuse et sexuelle : de la recherche au développement Presenter: de pratiques psychothérapeutiques Dr. Beth Clark, PhD, HEC-C, RCC, University of British Columbia, Vancouver, British Columbia inclusives et culturellement informées pour les personnes trans, non binaires As gender-affirming services are expanded across Canada and et leurs partenaires (Présentation en groupe) the US, trans and non-binary people are increasing able to obtain needed care. This work is certainly not complete and progress has Presenters: not been achieved without challenges. While our focus is often on Denise Medico, Professeure, UQAM + Centre de santé Meraki, the people in front of us and structures within our own institutions, Montréal, Québec it is important to both recognize and effectively resist the impacts of Gabriel J. Galantino, M.A., Sexologue psychothérapeute, pseudo-scientific rhetoric on our ability to provide the best possible UQAM + Centre de santé Meraki, Montréal, Québec gender-affirming care. This workshop will introduce learners to Isabelle Borduas, M.A. (cand.), Sexologue psychothérapeute, examples of pseudo-science in the scholarly literature on trans UQAM + pratique privée, Montréal, Québec health care, as well as commentaries written by experts in resistance Françoise Susset, Psychologist, Couple and Family Therapist, to these publications. Common “dog-whistle” messages (i.e., coded Meraki Health Center, Montreal, Quebec language) and disinformation efforts focused on invalidating and delegitimizing the experiences of trans people and undermining La thérapie de couple et la sexothérapie doivent développer des access to gender-affirming care will be highlighted. Evidence-based pratiques et des services inclusifs, culturellement informés et responses to these messages will be presented and discussed by affirmatifs. Or l’état actuel tant au niveau de la recherche que du attendees. Particular attention will be paid to issues involving trans développement des savoirs pratiques est encore largement marqué youth and examples of how health care providers and other par une conception binaire des genres, hétéro et cisnormative. Ce professionals can advocate for evidence-based policy and care. panel mettra en discussion différents enjeux actuels pour Participants will be invited to collaboratively work through case l’accompagnement thérapeutique des problématiques liées à scenarios to build skills in identifying and counteracting pseudo- l’intimité et la vie affective et sexuelle chez les personnes de la scientific arguments that they may encounter in their institutions, diversité de genre et leurs partenaires. their communities, the media, and the scholarly literature. The workshop facilitator is a health care ethicist whose research focuses 12:30 - 1:30 pm Lunch & EXHIBITS on health care access and equity for trans communities. Learning 1:30 - 2:30 pm CPATH AGM Ballroom Centre objectives include: gaining insight into the presence of pseudo- science within the scholarly literature in the post-truth era; increasing (Simultaneous Translation) understanding of common coded arguments used to invalidate 1:30 - 2:30 pm POSTER SESSIONS the experiences of trans people and undermine access to gender- with Authors Present affirming health care; and building skills related to identifying and countering pseudoscientific arguments in order to promote evidence- ______based care in institutions, communities, the media, and the scholarly. POSTER SESSIONS For List of Poster Sessions and Descriptions see page 58 ______

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57E. Navigating Trans Health Across a health and medical professionals to learn from the challenges Lifespan (and a province) Intersectionality, faced in one province in Canada which has two “competitive” urban centres, large rural areas and many expert trans affirming Inclusion and the Decolonization of Trans professionals who are just trying to do the best that they can within Health in Alberta (Panel) the system for trans youth to those at end of lifespan. Facilitator: Dr.Ted Jablonski MD CCFP FCFP (FP urban), Associate, 62E. Learning from Autistic Trans Crowfoot Village Family Practice Medical Lead, Calgary Community: Lessons in Ableism, Attitudes, Foothills PCN Clinical Assistant Professor, University of and Allyship (Panel) Calgary, Department of Family Medicine Clinical Associate, Men’s Sexual Health Clinic, Southern Alberta Institute of Presenters: Urology Medical Director, Jablonski Health and Skipping Dr. Jake Pyne, Banting Postdoctoral Fellow, University of Stone Foundation, Calgary, Alberta Guelph, Guelph, Ontario Panelists: Bridget Liang, PhD Student / Activist, York University, Psychiatrists: Toronto, Ontario Dr. Joe Raiche MD FRCPC DABPN, Foothills Medical Centre, Noah Adams, PhD Student / Activist, Ontario Institute for Calgary, Alberta Studies in Education, Toronto, Ontario Dr Michael Marshall, MBBS, MRCPsych, CCT Psychiatrist Increasingly, trans communities rightly expect to speak for - Transgender Health Program Director, The Gender themselves in the public realm. Autistic trans and non-binary Program Clinical Lecturer Faculty of Medicine and people, however, cannot count on being heard in the same way Dentistry Department of Psychiatry, Edmonton, Alberta and often finding themselves spoken for by family members and Psychologist: service providers. In the field of trans health care, the absence Ashleigh Yule, MA, R. Psych. Doctoral Candidate, School of an autistic trans perspective has troubling implications. This and Applied Child Psychology, University of Calgary panel will highlight the voices of autistic trans people and their Lead Psychologist, Skipping Stone Foundation District supporters in a discussion of current research and advocacy Consultant, Fort McMurray School Districts Director, efforts. Challenging allistic (non-autistic) and neurotypical Ashleigh Yule Child Psychology Inc, Calgary, Alberta assumptions, we will explore a number of pressing questions: Dr. Jillian Demontigny BSc MD CCFP, The Taber Clinic, Taber, What research can we use to understand what autistic trans Alberta people need? How do the assumptions made about autism impact Dr. James Makokis BSc MHSc MD CCFP, Family Medicine, the type of services autistic trans people receive? What does Kinokamasihk (Kehewin Cree Nation) and Maskehkosihk research tell us about the needs of autistic children and youth (Enoch Cree Nation), British Columbia with respect to gender and sexuality? What parallels exist between Ob/Gyn Surgeon: trans movements and the movement for neurodiversity? How do Dr. Fiona Mattatall MSc MD FRCSC, Chrysalis Obstetrics and identities like race and class complicate experiences of ableism Gynecology, Calgary, Alberta and transphobia, as well as collective struggles for justice? And The Alberta Advantage? Where are we now and where are we what can neurotypical service providers and researchers do as going? Are we serving the needs of our gender diverse community? allies? This panel will focus primarily on the work that autistic trans Private vs public funding, centralizing / de-centralizing, urban / people are doing to shape their worlds. rural, budget proposals for new initiatives… what is the future of trans health in our province for trans folks along their lifespan? Learn from our successes and short comings. Towards Optimized Practice (TOP) guidelines on the management of trans affirming surgery in Alberta will be published in 2019. How will it be implemented and will it change the landscape? Is it possible to transition from silos of medical care, isolated islands of primary care “champions”, private psychologists, multiple centers of expertise vying for government dollars to a systematic, unified, collaborative and multi-disciplinary approach to TGNC care in our province. How does primary care work with specialty care? How do rural professionals survive and flourish when many resources are urban? How do we all communicate and be kind to each other? This highly interactive session will be a forum for all mental

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101E. Enhancing Natural Supports: 56E. Trans and Non-binary Youth in Clinical Working with Families of Transgender Youth Care: New Research from Trans Youth CAN! (Oral Presentation) and the Stories of Care Project (Panel)

Presenter: Presenters: Laura Shiels, LGBTQ2S+ Natural Supports Worker, Centre for Dr. Greta Bauer, Professor, Epidemiology and Biostatistics, Sexuality, Calgary, Alberta Western University, London, Ontario Dr. Margaret Lawson, Pediatric Endocrinologist, Children’s By examining research on protective factors for transgender youth, Hospital of Eastern Ontario (CHEO), Ottawa, Ontario this workshop will explore how enhancing natural supports can Dr. Annie Pullen Sansfaçon, Professor of Social Work, produce better health outcomes for transgender youth later in life. A University of Montreal, Montreal, Quebec Natural Supports Framework puts an emphasis on an approach that Dr. Frank Suerich-Gulick, School of Social Work, University of centers the relationships in our clients lives as basic needs integral Montreal, Montreal, Quebec to their health. For transgender youth, this approach is particularly important as research done by the Family Acceptance Trans and non-binary youth follow various pathways to access Project at San Francisco State University illustrated how family gender-affirming medical care. relationships can have a profound impact on youth’s wellbeing: Parental support can greatly impact this process and youth well- “… transgender young adults who were highly rejected by their being. We present new research from two companion studies: Trans parents and caregivers had poorer health than other gay or Youth CAN!, a quantitative study of youth referred to clinics transgender young people who were not rejected by their families. for puberty suppression or hormones, and Stories of Care project, a They had more problems with drug use. They felt more hopeless. qualitative study of trans children and youth attending clinics. And they were much less likely to protect themselves from HIV or Baseline interviewer-administered surveys for youth aged puberty sexually transmitted diseases.” In this interactive session to 15 years in Trans Youth CAN! were conducted at first visit for participants will define and identify natural supports in youth’s lives, puberty suppression or hormone therapy at 10 clinics in Halifax, reflect on the complexities of engaging natural supports, explore Montreal, Ottawa, Toronto, Hamilton, London, Winnipeg, Edmonton, tools and strategies to integrate this approach into their practice, Calgary, Vancouver. Semistructured interviews for the Stories of Care and leave with the confidence to build and bolster supports for their Project were conducted with children and youth at transgender clients. three clinics: Montreal, Ottawa, Winnipeg. All clinics are gender- At Centre for Sexuality we design all of our workshops to be affirming, providing the opportunity to live in and express the gender interactive and facilitate discussion. In this workshop, participants most comfortable for the child without restriction or will be engaged through an ice breaker activity that builds criticism. We will describe sociodemographic, health, and family understanding of the workshop’s key goals, time and space to ask characteristics of youth referred for care, and where possible questions about integrating a Natural Supports Framework, a small compare this group to data on broader communities of trans and group brainstorm of the anticipated barriers in engaging family non-binary Canadian youth to identify factors that influence need members (or other natural supports) of transgender youth, and for or access to care. We will examine pathways to gender-affirming scenario based activities. care, including wait times, referral sources, and prior providers. We will also report on relationships between pathways and a number of factors that may influence access to care. We will examine types of support received by youth, including parental support, and their associations with youth well-being. Using adapted Grounded Theory methodology, we will explore stories of youth to understand their lived experience and how it relates to care-seeking. Four recurring themes emerged from preliminary analysis: Coming out to parents and reasons for seeking care, desired medical interventions and expectations, outcomes of medical interventions, and overall experiences with clinical care and service received. Ultimately, we aim to help clinicians, youth, and families to better navigate access to care and to better support trans and nonbinary youth.

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7F. Les chirurgies d’affirmation de genre minority health and 4 on gender minority health. All 7 programs (Présentation en groupe) were interested in increasing the level of resident exposure to sexual minority health and 6 programs were interested in the Presenters: same for gender minority health. All program directors expressed Henri Labelle, Travailleur Social et Psychothérapeute, interest in implementing a formal curriculum or module, if it Ordre des Travailleurs Sociaux du Québec / Ordre des was developed, on these topics. The most desired methods of psychologues du Québec, Montréal, Québec instruction, in order of preference, were case-based presentations, Daphney Prophète, Infirmière clinicienne, Ordre des e-modules, didactic lectures, and patient advocacy groups. Infirmières du Québec, Montréal, Québec Conclusion: Of the 7 Canadian ObGyn residency program directors included in this study, there is considerable interest in Nous présenterons le processus chirurgical des patients du GrS increasing resident exposure to LGBTQ2SIA+ health teaching. Montréal. De la constitution du dossier préopératoire aux soins These results support the importance of developing a standardized postopératoires, différents thèmes seront abordés dont: Canadian Reproductive Health curriculum specific to ObGyn - GRS Montréal residents on sexual and gender minority health. - Les soins préopératoires - Les chirurgies d’affirmation de genre - Les soins postopératoires 38E. Are Pediatric Residents in Canada - Les ressources nécessaires à la convalescence Receiving Enough Education on - Comment soutenir les personnes transgenres Gender Diversity? A National Survey of approche interdisciplinaire Pediatric Residents and Program Directors - Période de questions (Oral Presentation)

Presenters: Medical Education / Éducation médicale Dr. Alexa Marr, Children’s Hospital of Eastern Ontario, 2. University of Ottawa, Ottawa, Ontario Dr. Amy Robinson, MD, FRCPC, 1. CHEO Research Institute, 30E. LGBTQ2SIA+ Health Curriculum 2. Division of Adolescent Health, Department of Pediatrics, in Canadian Obstetrics & Gynecology CHEO, University of Ottawa, Ottawa, Ontario Residency Programs (Oral Presentation) Dr. Margaret Lawson, MD, FRCPC, 1. Division of Endocrinology and Metabolism, Department of Pediatrics, Presenters: CHEO, University of Ottawa, 2. CHEO Research Institute, Dr. Aleah Hazan, LGBTQ2SIA+ Health Curriculum in Ottawa, Ontario Canadian Obstetrics & Gynecology Residency Programs, Dr. Steven Feder, Associate Professor, University of Ottawa, Obstetrician/Gynaecologist, University of British Columbia, Chief Division of Adolescent Medicine, Children’s Hospital Vancouver, British Columbia of Eastern Ontario (CHEO) Co-Director Diversity Clinic Dr. Nicole Todd, LGBTQ2SIA+ Health Curriculum in Canadian CHEO, Ottawa, Ontario Obstetrics & Gynecology Residency Programs, Pediatric and Adolescent Gynaecologist, University of British Objective: To examine resident and program director (PD) Columbia, Vancouver, British Columbia perspectives on the state of postgraduate medical education on gender diversity in Canadian pediatric residency programs. Obstetricians and Gynecologists (ObGyn) in Canada provide care Background: Primary care providers are seeing more gender for women from infancy to adulthood, regardless of their sexual diverse children and youth with an exponential growth in referrals orientation or gender identity. Currently, we do not know how to Canadian specialty clinics. There is currently no mandatory Canadian ObGyn resident physicians receive lesbian, gay, bisexual, curriculum on gender diversity for Canadian pediatric residency transgender, queer, 2-spirit, intersex, or asexual (LGBTQ2SIA+) programs. health training to achieve competence in LGBTQ2SIA+ care. Methods: Cross-sectional online surveys in English and French Objectives: The objectives of the current study were to determine distributed through REDCap to PDs and residents in the 17 if and how Canadian ObGyn residents are receiving LGBTQ2SIA+ Canadian pediatric residency programs. Data were analyzed by health training during their residency and program director interest descriptive statistics with 95% confidence intervals. in increasing exposure to resident LGBTQ2SIA+ training, including Results: Response rate was 88.2% from PDs and 24.5% from preferred methods of instruction. residents. Amongst PDs, 14.3% [95%CI: 6.3, 22.3] reported they Study Methods: An online prospective survey was sent to program had a formal curriculum for gender diversity teaching while 66.7% directors of all 16 Canadian postgraduate ObGyn programs. [58.2, 75.1] said there was diversity care for children and youth Results: Completed surveys were received from 7 program in their hospital/community, 80.0% from a multidisciplinary team. directors. Three programs reported formal teaching on sexual

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Sixty-four percent [53.3, 75.2] of PDs estimated their residents 4:15 - 5:45 pm received ≤ two hours teaching on gender diversity, with 53.3% [44.4, 62.3] reporting specific teaching on diagnosis of gender dysphoria in CONCURRENT SESSIONS adolescents and 40.0% [31.2, 48.8] on diagnosis in children, social transitioning, and mental health. Residents reported Focus on Intersectional Realities comfort levels ≤ 50% on all specific gender diversity topics. Amongst Regard su les réalités intersectionelles residents, 73.8% [67.9, 79.6] said that mandatory time in a gender diversity clinic would be the most effective teaching tool while Transforming Community: PDs favoured an online module (66.7% [58.2, 75.1]) followed by 27E. mandatory time in a gender diversity clinic (60.0% [51.2, 68.8]). Transgender Older Adults’ Stories Barriers to teaching included lack of time and space in the pediatric of Growing Older (Oral Presentation) curriculum. Over 90% of residents indicated that more teaching is Presenter: required. Ashley Flanagan, PhD Candidate, Aging, Health, and Conclusions: PDs and residents report significant variability in Wellbeing Interdisciplinary Program of the Faculty of education about gender diversity in youth. Residents reported low Applied Health Sciences, University of Waterloo, comfort levels with this topic and need for further education. A Waterloo, Ontario formal pediatric postgraduate curriculum on gender diversity is recommended for Canada. What do you see when you think about the later years of your life? For many transgender older adults, the discrimination they 45E. Starting a New Transition Related Surgery have faced throughout their lives does not end at the age of 65 Program: The Successes, The Challenges (Cronin & King, 2010). Rather experiences of heterosexism and cisgenderism—which may now also be compounded with ageism (Oral presentation) and age-related issues—persist and influence visions of old age Presenters: that often hold images of isolation, invisibility, harassment, and Emery Potter, Nurse Practioner, Women’s College Hospital, depression (Butler, 2004). Toronto, Ontario Recognizing the benefits of social engagement and participation, Dr. Yonah Krakowsky, Urologist, Womens College Hospital, community-based social support programs and services may be Toronto, Ontario one way to combat the negative impact that lifelong experiences of discrimination, harassment, and/or violence; higher levels of A new Transition Related Surgery program opened at Women’s perceived stress; and general aging fears have on trans older adults’ College Hospital in Toronto, Ontario in 2018. As our program begins experience of aging and old age. Unfortunately, there are very few to grow, we are witness to a number of successes and programs that specifically welcome and celebrate the diversity challenges. In this presentation we would like to walk through the of old age. current landscape of transition related surgeries here in Ontario Therefore, this study was interested in exploring the triumphs and since the regulatory changes that shifted access in 2016. Our challenges experienced by existing community-based social support program currently offers a range of surgical services from chest programming available to trans older adults living in the Greater masculinization, breast augmentation, orchiectomy, scrotectomy, Toronto Area (GTA). Specifically, this presentation highlights trans complication management and in June 2019 we will be starting older adults’ experiences of aging and community through creative our vaginoplasty program. As we build our surgical expertise and arts-based representations of stories shared by participants during access, the need for these surgeries continues to grow. There were the authors dissertation research. Through the use of creative over 1600 approvals for Ontario Health Insurance Plan covered analytic practices of representation, we become immersed in surgeries since 2016. While there are only a few providers offering ways of doing research differently that facilitate the creation of these services in Ontario, our access issues move from the referral more accessible methods for establishing new programming and/ process to the surgical side - and our wait lists are growing. In this or extending existing programming to better support transgender presentation we will focus on what we have done to help increase older adults in Canada – as well as demonstrating the many our services while outlining the work that remains to be done. complexities of identity, aging, and community. By focusing on social engagement and participation, we create opportunities to 4:00 - 4:15 pm Break & EXHIBITS reduce the risk of social isolation and lack of social support (and subsequent consequences for health and wellbeing) for transgender older adults living in Canada.

43 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

48E. Transgender Law - Emerging Issues HIV and Determinents of Health (Oral Presentation) Le VIH et les déterminants de la santé

Presenter: Adrienne Smith, Lawyer, Law Society of British Columbia, 35E. Access to Gender-affirming Medical Vancouver, British Columbia Care for Trans Women Living with HIV in Canada: A Mixed Methods Study This presentation will provide and overview of the changes in law (Oral Presentation) affecting transgender people since the last CPATH conference. The focus will be on explicit human rights protection for trans Presenters: people, hate speech and the backlash against transgender Ashley Lacombe-Duncan, Assistant Professor, University of activism, and youth consent to healthcare considerations from the Michigan School of Social Work, Ann Arbor, Michigan perspective of British Columbia. It will be accessible to non-lawyers Yasmeen Persad, Research Coordinator, Trans Women HIV and will be of particular interest to folks working with trans youth Research Initiative, Women’s College Research Institute, and their families. Toronto, Ontario

Background: We know that access to medical transition is 49E. An Update on a Phenomenological incredibly important to support the health and wellbeing of trans Study of the Lived Experience of Asian people who want to access it; however, preliminary studies suggest Transgender Youth in Canada that trans (Oral Presentation) women living with HIV may experience unique barriers to access to medical transition at the intersection of trans identity and HIV Presenter: experience. We aimed to describe these barriers and facilitators to Sulin Tan, MA, PsyD Candidate, Adler University, Vancouver, access to medical transition among trans women living with HIV in British Columbia Canada. This presentation is a follow-up to my presentation at the 2017 Methods: This convergent parallel, mixed-methods study drew CPATH conference. This is a phenomenological study utilizing an on cross-sectional quantitative data from 48 trans women living intersectional framework to examine the lived experience of with HIV, analyzed using descriptive and bivariate analyses, and individuals with triple minority identities with regards to gender, qualitative semi-structured interview data from a sub-sample of age, and ethnicity living in Canada. My previous presentation 11 participants, analyzed using framework analysis. The primary focused on the literature review and rationale for this study - i.e., outcome was self-reported transition status (completed/in the the paucity of existing research and the tendency to extrapolate process of medical transition versus planning to but have not from research on LGB youth, which obscures the voices of begun medical transition), only measured among those who gender-variant, ethnic minority youth. The current follow-up indicated they wanted to access medical transition. presentation will focus on the results and implication of findings. Findings: Just over half of participants reported fully/being in the Semi-structured interviews were conducted with 8 Canadian process of medical transition (52.1% [n=25/48], 95% CI: 37.5%- gender-diverse youth of Asian ethnicity that pertained to identity 67.6%), with one-fifth reporting planning to but having not begun development, self-disclosure, challenges, and resiliency. medical transition (18.8% [n=9/48], 95% CI: 8.3%-29.2%). Integrative phenomenological analyses revealed themes related to Factors statistically significantly associated with not having begun the development of gender identity, ethnic identification, impact of one’s medical transition included housing instability, transphobia, community connections, implicit cultural rules, power differentials, HIV-related stigma and barriers in access to care. Qualitative resilience, and systemic factors. Implications for responsible care findings revealed how transition experiences were influenced by provision in the community will be discussed. community norms, passing and class privilege, HIV, and structural barriers. Mixed-methods findings showed positive relationships ______between trans women living with HIV and HIV care providers in terms of trans and HIV healthcare. Conclusions: There are many structural barriers to access to medical transition experienced by trans women living with HIV, including stigma and lack of access to social determinants of health. Stigma must be addressed in a broad range of healthcare settings, in addition to structural barriers, to increase access to gender-affirming HIV care and medical transition for this population.

44 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

43E. Mental Health and Psychological 50E. “From Surviving to Thriving”: Wellbeing Among Trans Women Findings from the Toronto Trans Coalition Living with HIV in Canada (Oral Presentation) Project’s Needs Assessment of Trans and Nonbinary People in Toronto Based on Presenters: Yasmeen Persad, Research Coordinator, Trans Women HIV the Social Determinants of Health Research Initiative, Women’s College Research Institute, (Oral Presentation) Toronto, Ontario Presenters: Ashley Lacombe-Duncan, Assistant Professor, University of Evan Vipond, Toronto Trans Coalition Project, Toronto, Ontario Michigan, School of Social Work, Ann Arbor, Michigan Susan Gapka, Toronto Trans Coalition Project, Toronto, Studies show high rates of depression and post-traumatic stress Ontario disorder (PTSD) among trans women; yet scant literature has In Fall 2018, the TTCP conducted a needs assessment of trans assessed mental health among trans women living with HIV and nonbinary people in Toronto based on the social determinants (WLWH). This study characterized mental health and assessed of health. The needs assessment used mixed methods, including a for associations between individual, social, clinical, and structural comprehensive online survey and in-person focus groups. The characteristics and mental health outcomes for this group. online survey focused on the needs of the trans and nonbinary Methods: Baseline data from the Canadian HIV Women’s Sexual community in the areas of employment, financial security, housing, and Reproductive Health Cohort Study (CHIWOS), a longitudinal education, health and wellbeing, and social inclusion. We not only community-based research conducted in British Columbia, focused on the intersections of economic wellbeing, living and Ontario, and Quebec (n=1422 WLWH, including 54 trans WLWH) working conditions, access to education, and health services, we were used to cross-sectionally assess depressive symptoms also focused on experiences of discrimination and oppression (CES-D scale, 10 or higher indicating clinically significant that trans and nonbinary people face in regards to the above depressive symptoms), PTSD symptoms (PLC-C scale, 14 or mentioned determinants. These intersections include gender higher indicating clinically significant PTSD symptoms), and identity, dis/ability, race, class, sexuality, citizenship status, mental health-related quality of life/MH QoL (SF-12 mental and age. In addition to the online survey, which garnered 181 health subscale). Univariate linear regression was used to test responses from the City of Toronto, we also conducted nine associations between each of the three outcomes and individual, in-person focus groups with a total of 31 participants. The focus social, clinical, and structural correlates. groups enabled us to discuss and better understand the Findings: Among 54 participants, 44.2% reported clinically gaps in services for trans and nonbinary people, and to discuss significant depressive symptoms, 45.3% clinically significant PTSD viable options for addressing these gaps. The focus group symptoms, and mean MH-QoL was low (42.1, SD: 15.4). discussions centered the voices of trans and nonbinary community Internalized HIV stigma and domestic violence were associated members who are disabled, un(der)housed, and dealing with with more frequent depressive symptoms, with sexual relationship precious employment and financial insecurity. Our presentation power (high/medium versus low), social support, and less will focus on the key findings and recommendations from the difficulty meeting housing costs associated with less. Internalized Needs Assessment, as well as the importance of community- HIV stigma was associated with more severe PTSD symptoms, based and peer-led research, and intersectional research. whereas resilience and social support were associated with less. The Toronto Trans Coalition Project (TTCP) is a community- Resilience and social support were also associated with higher based, non-for-profit organization run entirely by trans community MH-QoL, whereas internalized stigma was associated with lower. members working to improve the lives of trans and nonbinary Conclusions: Findings show the importance of considering people in Toronto based on the social determinants of health. intrapersonal (e.g., resilience), interpersonal (e.g., violence), and TTCP uses a peer-led model, that is by-trans and for-trans, to structural (e.g., housing security) factors to support trans better understand the needs of our community and enable trans WLWH’s mental health. Trauma-informed care may be a salient and nonbinary people to thrive, rather than simply survive. model of care for trans WLWH. Social support programs that link trans women together and build community connections may also be an important mechanism to increase social support, build resilience, and combat internalized stigma.

45 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

96E. Dynamic and Diverse approaches to 102E. Clinical Case Presentation From an Supporting Dynamic and Diverse Youth Informed Consent Perspective (Workshop) (Workshop) Presenter: Presenters: Françoise Susset, Psychologist, Couple and Family Therapist, Cathy Maser, MN, Nurse Practitioner, Team Lead Meraki Health Center, Montreal, Quebec Transgender Youth Clinic, Division of Adolescent Medicine, For almost a century, clinicians have functioned as “gatekeepers” Sick Kids Hospital, Toronto, Ontario for trans individuals seeking transition related services. Katie Stadelman, Social Worker-MSW, Division of Adolescent Many clinicians are committed to moving away from this role medicine and Department of Psychiatry, The Hospital for but still struggle with what approach to adopt that respects and Sick Children, Toronto, Ontario prioritizes their client’s needs while considering the various Dr. Mark Palmert, Endocrinologist, Associate Chair of potential risks to an individual that presents with a more complex Pediatrics (Ambulatory Care) at SickKids, The Hospital for mental health profile. Sick Children, Toronto, Ontario An “Informed consent” approach has been proposed to replace The need for services for trans and gender diverse youth far “gatekeeping” but what does this approach mean for mental exceeds the current resources available in most sectors across health professionals charged with producing letters of support for Canada. The reality of fiscal constraints and lack of dedicated and transition-related services? secure funding sources has inspired creativity, collaboration and Beyond a definition of “informed consent” that focuses mainly on innovation amongst those of us working with this population. the physical impact of hormones and surgeries, this case based Objectives: The purpose of this workshop is to showcase and workshop will focus on what the approach means for mental share some of the approaches taken by a small and dedicated health providers. team of health care providers in a hospital based clinic in Ontario Moving away from a “gatekeeper” role is still a struggle for many with the aim of improving access to care, decreasing wait times clinicians when it comes to clients who face a greater number of between clinic visits and building capacity for care into the mental health and psychosocial challenges. community. In an informed consent perspective, the clinical assessment allows Methods: Facilitators will describe and share a variety of us to identify and address the potential challenges a client may approaches utilized to enhance care from an inter-professional face throughout the transition process and beyond. It allows us to team perspective and engage participants in a discussion about work collaboratively with our clients, helping to remove obstacles what has worked and what might be done differently. Additional that may be standing in the way of their goals. areas for discussion will include: identifying and prioritizing Objectives: patient/client needs, identifying and overcoming barriers and - To focus on our current practice; implementing innovative approaches to care delivery. - To identify the ways we still struggle with gatekeeping, especially Results: Participants will have the opportunity to share and when dealing with complex cases; collaborate with colleagues across sectors and regions to - To identify pathways to working consistently with an informed strategize, learn about, and work toward the development of new consent approach. and innovative approaches within the confines of existing practice models and settings.

46 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

2F. Bonjour Sam : sensibiliser les jeunes par Providing Care for Trans, Non-Binary, Gender le jeu (Atelier) Creative Children and Youth Soins offerts aux jeunes et enfants trans, Presenter: Antoine Beaudoin Gentes, Chargé de projet pour Enfants non binaires et créatifs transgenres Canada, Montréal, Québec Co-presenters: 25E. A Phenomenological Study Of Dr. Annie Pullen Sansfaçon, Cofondatrice d’Enfants Psychologist Experiences Providing Care transgenres Canada et professeure en travail social à For Transgender Youth In Canada L’UDM, École de travail social de l’Université de Montréal, (Oral Presentation) Montréal, Québec Chloe Viau, Chargé de projet pour Enfants transgenres Presenter: Canada, Montréal, Québec SJ Drake, Psy.D., Adler University, Vancouver, British Valeria Kirichenko, MSW Student, University of Montreal Columbia Gender Creative Kids, Montréal, Québec Transgender youth face experience multiple unique psychosocial Le projet Au coeur de toi (the You inside project) a été créé par stressors and sources of minority stress that increase their l’organisme Enfants transgenres Canada, en collaboration avec la vulnerability to mental illness and distress (Hendricks & Testa, firme de design montréalaise indépendante LG2. Sam est le 2012). premier outil éducatif transgenre au monde et sa mission est Mental health care for transgender youth requires integrated toute simple et très complexe à la fois : enrayer la transphobie knowledge of psychological and gender development, a critical avant qu’elle ne commence. En complément à Sam et à son understanding of psychosocial perceptions of gender, awareness implémentation dans le milieu scolaire primaire québécois, of socio-cultural barriers to wellness experienced by transgender une équipe d’expert.e.s sur les enjeux trans s’est penché sur la youth, and experience navigating multiple systems. Psychologists création d’outils pédagogiques pertinents pour accompagner Sam in Canada provide care for transgender youth in multiple roles dans les classes du Québec et du Canada. Cet atelier vise donc à (Vanderburg, 2009), amid unresolved ethical dilemmas (Schumer présenter Sam et ses possibilités transformatrices au sein du & Tishelman, 2015; Stein, 2012), with limited specialized milieu scolaire. Ce projet s’arrime également avec les training and standards of best practice (Coleman et al., 2011). apprentissages du nouveau programme d’éducation à la sexualité Semistructured interviews and interpretive phenomenological du Ministère de l’Éducation. analysis examine the experiences of psychologists in Canada who Misant sur le ludisme, Sam est un outil puissant qui permet are providing care for transgender youth. Results clarify unique d’aborder les réalités transgenres et non binaires chez les enfants roles held by psychologists in the care of transgender youth, avec des groupes de jeunes écolier.ère.s. highlight the challenges faced in providing care, reveal decision Les qualités du projet ont été soulignées maintes fois, et ce dans making processes and implemented solutions to these challenges, plusieurs concours, remportant ainsi 2 prix STRAT lors du gala and produce recommendations for training, clinical practice, and Infopresse : le Grand prix annuel et le prix Grande cause remis development of programs and standards of care. à un organisme à but non lucratif. Nous sommes également récipiendaire d’un CLIO Awards remis à New York, de deux prix or au London international Awards et d’un prix argent au Advertising and Design Club of Canada. Nous avons aussi été finaliste pour le prix Droits et liberté de la Commission des droits de la personne et des droits de la jeunesse, en plus de remporter un prix Grafika. Cet atelier sera animé en duo par Annie Pullen Sansfaçon, cofondatrice de l’organisme et instigatrice du projet Au coeur de toi, également professeure en travail social à l’université de Montréal, et par Antoine Beaudoin Gentes, chargé de projet pour l’organisme. Ce sera l’occasion privilégiée de faire connaître Sam au public présent, en plus d’y présenter les mécanismes et effets constatés auprès des jeunes à ce jour.

47 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

51E. The Ideal and the Actual: 112E. Desistance Statistics, Gender Exploring the Integration of Trans Inclusion Production, and Trans and Gender Diverse Policies in Schools (Oral Presentation) Youth: The Ongoing Logic of Conversion Therapy (Panel) Presenters: Dr. Tanya Surette, PhD MOC, Registered Psychologist. Presenter: Lethbridge, Alberta Kaeden Seburn, Carleton University School of Social Work, Serena Visser, PhD student, Registered Clinical Social Ottawa, Ontario Worker, Cultural, Social and Political Thought, University of Lethbridge, Lethbridge, Alberta There has been significant academic and clinical discussion in the last decade about the best practices for supporting and providing In 2016, the Alberta government released the “Guidelines for best transition-related health care to trans and gender-diverse practices: Creating learning environments that respect diverse children and youth. While there have been many protocols sexual orientations, gender identities, and gender expressions” for and practices suggested and advocated for the perspectives of the purpose of enabling school authorities to use best practices actual young trans and gender-diverse people have not been in creating learning environments that respect the safety and meaningfully represented. inclusion of students with diverse gender identities, gender Drawing on existing academic literature from scholars and expressions, and sexual orientations. At the same time, the clinicians in the fields of trans health and trans children and province’s education minister ordered all school divisions in youth, as well as emerging youth-led research, this presentation Alberta to submit a policy specifically addressing the inclusion, will explore the contemporary state of transition-related healthcare protection, and support of gender and sexual minority students. for trans and gender diverse children and youth in parts of North While all school divisions in the province drafted their policies, America and Western Europe, with a focus on protocols for the gross discrepancies continue to exist between these policies, administration of hormone blockers. I will discuss the evolving their implementation into practice, and student experiences of perspectives and common practices for working with children and inclusion. This presentation aims to raise consciousness about youth from the 1960s to the present and demonstrate how similar the specifics of this disparity, discovered through a multi-method logics have remained intact across this time period. In particular, research project undertaken in 2017-2018. Through the use of I will argue that some of the logics that are often used to advocate narrative inquiry, this study employed in-depth interviewing and for and guide prescribing hormone blockers to trans youth are critical discourse analysis of pertinent policy and legislative derived from the logic of conversion therapy, presented through documents, drawn in as field texts, to explore the impact of the discourse of ‘desistance’ and the desire of clinicians to this disparity on two trans students navigating public secondary produce normative adults. This remains true in 2019, despite the schools in two different rural Southern Alberta school districts. widespread understanding of conversion therapy as a harmful, This particular area was selected due to significant controversy and in some jurisdictions illegal, practice, and the increasing which erupted, as captured in the media, in reaction to the recognition of desistance as a harmful and inaccurate concept. aforementioned guidelines. This project found vast discrepancies ______between the ideal and the actual; it is clear that at a systemic level, students in this largely conservative area of the province continue to experience transphobia, exacerbated by schools’ misalignment 6:30 - 7:00 pm RECEPTION Foyer Salle de Bal with government supported guidelines. This study challenges the idea that government mandated policy development equates to the 7:00 - 8:00 pm GALA DINNER Ballroom Centre implementation of trans supportive school practices, and suggests that further efforts are required at the provincial, divisional, and 8:00 - 11:30 pm FSU CABARET followed by school levels to see the translation of intention into practice. DJ Fluffy Soufflé and Dancing Practical implications for educators and educational leaders will Ballroom Centre also be discussed.

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48 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

CPATH 2019 Conference Program

Sunday, November 3 / dimanche 3 novembre, 2019

7:00 - 8:00 am Breakfast 40E. The CPATH Ethical Guidelines for 7:00 - 8:00 am Caucusing Opportunities Research Involving Transgender People & Communities: Returning the Final Document 8:00 - 9:30 am (Oral Presentation)

CONCURRENT SESSIONS Presenters: Dr. Zack Marshall, McGill University, Montreal, Quebec Knowledge translation and exchange Dr. Greta Bauer, University of Western Ontario, London, Ontario L’application et le partage du savoir Dr. Annie Pullen-Sansfacon, Universite de Montreal, Montreal, Quebec Dr. Jake Pyne, University of Guelph, Guelph, Ontario 21E. Updates to Sherbourne Health’s Guidelines for Gender-Affirming Primary In 2013, the Canadian Professional Association for Transgender Health (CPATH) recognized the need to create an ethical Care (Oral Presentation) framework for research that addressed concerns not necessarily Presenter: included in the TriCouncil policy. The goal of this project was to Dr. Amy Bourns, Family Physician, SHerbourne Health Centre, promote greater research integrity through the development of Toronto, Ontario ethical guidelines for research involving trans people. Draft ethical guidelines were developed over a five-year period through a series Sherbourne Health’s guidelines for hormone therapy and primary of consultations at national and international conferences, targeted care for trans patients has been a valuable resource for providers in-person consultations with individual community and research delivering trans care in Ontario and beyond since the first edition experts, and an online feedback form distributed broadly to CPATH was made publicly available in 2009. These guidelines are rooted membership, trans community members, and researchers in in 15 years of experience providing gender-affirming care in an Canada. The consultation process has resulted in the identification urban primary care setting which is home to the largest number of six overarching principles for trans research, and a series of of trans and non-binary patients in Canada. With the support seventeen guiding questions. The overarching principles underline of Rainbow Health Ontario, the guidelines have been revised the importance of: 1) Attentiveness to Issues of Legitimacy and periodically to keep pace with emerging evidence and to evolve Impacts on Communities, 2) Engagement with Communities, 3) with cultural changes in the trans communities that Sherbourne Consent and Confidentiality, 4) Consideration of Diversity, Power, Health serves. Marginalization and Representation, 5) Accountability to This presentation will include a brief overview of the approach Participants and Trans Communities, and 6) Reflexivity on the Part taken to the most recent revision which included gathering input of Researchers and Research Teams. The development of these from providers representing multiple clinical disciplines, service guidelines highlighted specific ethical concerns in the arena of settings, provinces, and personal lived experiences. We will also research with trans individuals and communities. For student, cover the most salient changes in this edition and discuss the academic, community, and clinical researchers who focus on rationale for and implications of these changes, which include: gender diversity in their research, increased attention to research • Expanded discussion of considerations for non-binary patients integrity in relation to trans individuals and communities is • Incorporation of the ICD-11 diagnosis Gender Incongruence warranted. We take this opportunity to share the final version of • Discussion of alternate routes of hormone administration these guidelines with the community at CPATH and will discuss • Expanded discussion of HIV prevention and treatment in trans next steps in terms of knowledge mobilization and how these populations guidelines will be updated in the future. • An updated monitoring schedule with a reduced number of recommended routine bloodwork parameters • The role of primary care providers in supporting patients undergoing transition-related surgeries This short ‘sound-byte’ aims to give attendees a sense of the new evidence and evolving landscape of gender-affirming care, and how these changes might be incorporated into day-to-day clinical practice. 49 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

44E. Community-led Knowledge Translation 53E. Models of Care and Team activities and Exchange: Development of the in the Delivery of Transgender Primary Care: Inaugural Trans Women HIV Research An Ontario Case Study (Oral Presentation) Initiative Conference (Oral Presentation) Presenter: Presenters: Dr. Erin Ziegler, PhD, Assistant Professor, Ryerson University, Yasmeen Persad, Research Coordinator, Trans Women HIV Toronto, Ontario Research Initiative, Women’s College Hospital, Toronto, Background: Transgender individuals experience barriers accessing Ontario primary care. In Ontario, primary care is delivered through a variety Ashley Lacombe-Duncan, Assistant Professor, School of Social of delivery models. Literature supports team delivery of Work, Ann Arbor, Michigan primary care for transgender individuals in general, yet little is Background: A growing body of research has documented issues known about the delivery of primary care to transgender individuals affecting trans women living with HIV (WLWH) in Canada. Gaps in Ontario and the role of primary care teams. remain in healthcare and social services regarding gender-affirming Purpose: We attend to explore how primary care for transgender and comprehensive care for trans WLWH, addressable through individuals is delivered within three different primary care models in increased knowledge. Communityled knowledge translation Ontario; the roles primary care team members enact in care and exchange (KTE) activities have the potential to be culturally delivery; and barriers, enablers and clinical competence of grounded, address the most pressing community needs, and reach practitioners in delivering transgender care. those in change-making positions. This presentation details the Methods: Case study methodology was used to compare development and evaluation of the inaugural Trans Women HIV transgender care across three Ontario primary care models (solo Research Initiative (TWIRI) Conference, a community-led KTE practice, Family Health Team and Community Health Centre). Key activity. informants identified cases known to provide transgender care Methods: We undertook a community-led process of KTE project for case selection. Qualitative interviews were conducted, and development whereby Canadian HIV Women’s Sexual and documentary evidence and field notes were also collected Reproductive Health Cohort Study (CHIWOS) community team (November 2017 - January 2018). members (KTE champions) submitted tailored KTE project Main Findings: Practitioners clearly articulated their role and the proposals. Selected KTE champions were matched with academic activities they were responsible for in providing care, however they mentors. KTE champions and mentors received training on KTE tended to work independently. In cases with an interdisciplinary theory and project management and subsequently planned and team there was limited collaboration. Nurse practitioners, executed their envisioned projects. physicians, and counsellors contributed the most to the delivery Findings: In April 2018, a 2-day TWIRI conference was held (Day of care. Key challenges in delivering primary care included lack 1: Trans 101 Education and Training, n=25; Day 2: Research and of service coordination within organizations, and the need for practice considerations for working with trans WLWH; n=45) practitioner education. Continuing educational sessions, clinical in Toronto. Participants represented AIDS-specific and other practice guidelines, and mentorship aided capacity building. community-based organizations, and academic, governmental, Conclusions: Providing primary care to transgender individuals is healthcare, and private industry settings. Participants rated all within the scope of practice for primary care practitioners and can presented topics as 4 or 5/5 (1-very unhelpful, 5-very helpful), and be part of routine care delivered in solo practice, Family Health all would attend another conference on trans WLWH. Qualitative Teams, and Community Health Centre models of care. Primary care participant feedback called for more trans-led discussions, a greater team collaboration can be strengthened by regular team meetings. focus on mental health and trauma-informed care, and more Professional training needs to include transgender education examples of local best practices for working with trans WLWH. and continuing education opportunities need development. Conclusions: This community-led KTE strategy resulted in the development of a tailored activity that addressed an ______underrepresented population (trans WLWH) and reached those with potential to have impact on reducing barriers (health and social service providers, public health officials). Valuable lessons were learned about the need for meaningful community engagement and to build knowledge on pertinent topics (e.g., mental health).

50 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Heath & Reproductive Health changes. There is minimal evidence on effects of pubertal Santé reproductive, santé suppression on body composition and bone mass. Methods: Youth with GD followed in the Diversity Clinic of the 26E. Transmasculine and Non-Binary Children Hospital of Eastern Ontario, January 2006 to April 2018, Reproduction: Stories of Conception, were retrospectively reviewed. Fat percentage, lean body mass (LBM), bone mineral content (BMC), areal bone mineral density Pregnancy, and Birth (Oral Presentation) (aBMD) for Lumbar Spine (LS) and Left-Total-Hip (LTH), BMI, Presenter: vitamin D status, and affirmed gender were retrieved. Volumetric Olivia Fischer, University of British Columbia, Vancouver, BMD was calculated as bone mineral apparent density (BMAD) British Columbia at LS. Results: The study included 172 trans youth, 119 (69.2%) Similar to much of the population, trans people often seek transmales and 51 (29.7%) transfemales. Analysis of baseline parenthood. Findings from multiple surveys suggest that 25-50% of data found significantly lower Z-scores for LS aBMD, LS BMAD, trans individuals become parents (Stotzer, Herman, & Hasenbush, LTH aBMD, and BMC among transfemales, and high prevalence 2014). Many, if not most, transmasculine and non-binary (TMNB) of vitamin D deficiency or insufficiency in 55.3% (n: 96). The latter people retain their reproductive organs and their capacity to have was associated with LS aBMD, LS BMAD, and LTH aBMD Z-scores. children, and the majority of these individuals are of reproductive GnRHa associated changes were analyzed in a subgroup of 36 age when they transition (Obedin-Maliver & Makadon, 2016; (30.5%) transfemales and 80 (67.8%) transmales. Both transmales T’Sojen, Caenegem, & Wierckx, 2013). These TMNB individuals and transfemales showed reduced aBMD Z-scores for LS and LTH might choose to engage their bodies in conception, pregnancy, and but no significant change in BMI following GnRHa. Transfemales birth to create their families. This study investigated how showed significant increase in fat (%) Z-score, with further inverse transmasculine and non-binary individuals narrate their stories of change in LBM. conception, pregnancy, and birth. These five reproduction stories Conclusions: GnRHa was associated with no significant increase in were gathered using unstructured interviews and then assembled BMI. Transfemales’ changes in body composition were consistent into a chronological, cohesive narrative by the researcher. Each with affirmed gender. Many trans youth have low vitamin D. participant reviewed their narrative to ensure that their story was Vitamin D supplement should be recommended to all youth accurately captured, and their voice was preserved. These five with GD particularly those seeking pubertal suppression. GnRHa narratives were then woven into one collective narrative. The themes monotherapy negatively affects bone mass of trans youth as from this common narrative are what will be presented and evidenced by loss of LS, and LTH aBMD Z-scores. Management discussed. of youth with GD should include regular bone density and 25OHD assessments. 41E. Vitamin D Status and GnRH Agonist Effects on Body Composition and 111F. L’expérience des médecins lors de la Bone Mineral Density in Trans Youth prescription d’hormones aux adolescents (Oral Presentation) et jeunes adultes non-binaires : enjeux Presenters: médico-éthiques. (Présentation orale) Dr. Behdad Navabi, Division of Endocrinology & Metabolism, Presenter: Department of Pediatrics, Children’s Hospital of Eastern Dr. Raphaël Wahlen, Division de Santé des Adolescent, Ontario, Ottawa, Ontario Lausanne, Suisse et McGill Université, Montréal, Quebec Dr Ken Tang, Clinical Research Unit, CHEO Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, Ontario Objectif : Explorer le vécu et l’expérience des médecins québécois Dr. Karine Khatchadourian, Division of Endocrinology & en contact avec les adolescents non-binaires dans le contexte d’une Metabolism, Department of Pediatrics, Children’s Hospital demande de prise en charge médicale. Identifier et traiter les of Eastern Ontario, Clinical Research Unit, CHEO Research enjeux éthiques spécifiques de prise en charge des patients Institute, Children’s Hospital of Eastern Ontario, Ottawa, non-binaires rencontrés par les médecins. Observer les bases sur Ontario lesquelles les médecins prennent les décisions de prescription Dr. Margaret Lawson, Pediatric Endocrinologist, Co-Director d’hormonothérapie, et identifier les stratégies de gestion des of Diversity Clinic, Children’s Hospital of Eastern Ontario, décisions médicales Ottawa, Ontario, Professor of Pediatrics, University of Méthode : étude qualitative par théorisation ancrée réalisée en Ottawa, Ottawa, Ontario 2018-2019 auprès de 14 médecins : pédiatres, endocrinologues, endocrinologues pédiatres et médecins traitant, recrutés dans Youth with gender dysphoria (GD) may seek pubertal suppression to la province du Québec et interrogés, par entretiens semi-dirigés, relieve distressing effects of secondary sex characteristics. Puberty pour leur expérience dans la prescription d’hormonothérapie aux is a crucial stage in bone acquisition and time of body composition adolescents et jeunes adultes non-binaires. 51 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Résultats : Les demandes des patients non-binaires sont très Richard R. Pleak, Norman Spack, Dan H. Karasic, Herbert Schreier, variées et sortent parfois de la pratique habituelle du médecin Anouk Balleur, Amy Tishelman, Diane Ehrensaft, Leslie Rodnan, et des protocoles de soins. Ces situations se révèlent alors Emily S. Kuschner, Francie Mandel, Antonia Caretto, Hal C. Lewis & stressantes pour le médecin qui décrit parfois se sentir démuni, Laura G. Anthony (2016): Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in impuissant voire même incompétent en raison d’un manque Adolescents, Journal of Clinical Child & Adolescent Psychology, DOI: d’expérience, de formation ou encore de données disponibles 10.1080/15374416.2016.1228462 2. Jason Rafferty, COMMITTEE sur l’effet des traitements prescrits. Les soucis du médecin se ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, portent principalement sur les risques et incertitudes du traitement COMMITTEE ON ADOLESCENCE and SECTION ON LESBIAN, GAY, pour la santé du patient et sur la crainte de regrets. La réduction BISEXUAL, AND TRANSGENDER HEALTH AND WELLNESS. AAP de ces risques passe par de bonnes connaissances en santé Guideline: Ensuring Comprehensive Care and Support for Transgender trans et par une bonne connaissance de son patient. Les risques and Gender-Diverse Children and Adolescents, Pediatrics 2018;142; restants peuvent générer des dilemmes, en particulier entre DOI: 10.1542/peds.2018-2162 l’autodétermination du patient, sujet à discussion chez l’adolescent, et le principe de non-malfaisance du médecin. La décision de 105E. The Role of Peer Support in HIV/STI traitement se prend alors selon la position du médecin sur le Prevention Among Trans MSM (Workshop) partage de la responsabilité. La méthode du consentement éclairé est un outil permettant la responsabilisation du patient. Presenter: Sebastian Westerlund, AIDS Community Care Montreal, ______Montreal, Quebec This workshop will help community members and service providers understand the role and effectiveness of a peer-based sexual health 104E. “Avoiding Awkward Conversations”: program for gay, bi and queer transmen. Through experience, Living with Autism and Gender Dysphoria examples and activities, participants will develop specific (Workshop) approaches to sexual health, substance use, and STI prevention that meet the needs of transgender men who have sex with men. Facilitator: Beginning with a short presentation of existing programs and Dr. Sue Zinck, Dalhousie University/IWK Health Centre, services, the facilitator will then encourage audience participation Halifax, Nova Scotia through various activities such as role-playing and word association. Computer and projector access for Powerpoint presentation will be Children and teens living with an autism spectrum disorder (ASD) required. who have gender dysphoria have much in common with trans* youth who do not have an ASD, but they also have some unique features. Capacity to consent, variations in gender expression, 103E. Gender Affirming Practices for communication around and responses to social gender norms can Counsellors and Therapists (Workshop) present in unique ways. This workshop will present two composite Presenters: cases of a trans-masculine and a trans-feminine teen, each with Dr. Robin Westmacott, University of Manitoba, Winnipeg, an ASD, to illustrate these features and to highlight the needs of Manitoba the youth and their parents. The clinician consensus guidelines Dr. Reece Malone, Diversity Essentials, Winnipeg, Manitoba that inform these aspects of care, including capacity to consent to treatment, will be discussed. This workshop is designed for therapists who are new to working with gender diverse clients. We will discuss psychosocial Participants will review: development specific to gender identity, the impact of minority 1. Common presentations of gender dysphoria and autistic stress, factors to consider in a gender-sensitive and affirming spectrum disorder, including features of gender expression and intake, and how to work with ambivalence. challenges in transition that are unique among trans* youth We will highlight helpful aspects from cognitive-behavioural, with ASD. emotion-focused, and internal family systems models for targeting 2. Ways to educate parents of these youth, so they may better attachment, facilitating identity awareness and expression, and understand and support their child’s gender exploration, reducing minority stress. At the end the session, participants will: expression, and as appropriate, transition. 1. Identify psychosocial factors that impact identity development 3. The expert consensus guidelines on working with youth with an and interpersonal relationships ASD who are also gender dysphoric. 2. Acquire essentials for developing and conducting a gender- References: affirming intake 1. John F. Strang, Haley Meagher, Lauren Kenworthy, Annelou L. C. de 3. Identify how and when client ambivalence emerges and ways Vries,Edgardo Menvielle, Scott Leibowitz, Aron Janssen, Peggy Cohen- to approach ambivalence Kettenis, Daniel E. Shumer, Laura Edwards-Leeper,

52 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

98E. “Stop Assessing Us”: The Future of 16E. Creation of the Neo-Urethra in the Radial Translation-Related Youth Health Care Forearm Flap Phalloplasty: Our Experience (Workshop) and Outcomes (Oral Presentation)

Presenters: Presenter: Kaeden Seburn, Support and Education for Trans Youth Dr. Maud Belanger, FRCSC, Plastic Surgery, GRS Montréal, (SAEFTY), Ottawa, Carleton University, Ottawa, Ontario Montreal, Quebec Oliver Thorne, Support and Education for Trans Youth Purpose: Radial forearm flap is the most commonly chosen type of (SAEFTY), Ottawa, Carleton University, Montreal, Quebec phalloplasty for various reasons but even when comparing all the This workshop is designed for therapists who are new to working available flaps to create the neo phallus, the complications with gender diverse clients. We will discuss psychosocial rate for the neo-urethras are still very high and patients will have development specific to gender identity, the impact of minority strictures or fistula in as high as 70% of cases. stress, factors to consider in a gender-sensitive and affirming intake, Materials & Methods: In the last 40 phalloplasty we did, we have and how to work with ambivalence. We will highlight helpful aspects started to do the urethra connection in a separate surgery. We from cognitive-behavioural, emotion-focused, and internal family exteriorize the urethra that was previously elongated in the middle of systems models for targeting attachment, facilitating identity the scrotum and the neo-urethra from the phallus is also exteriorized awareness and expression, and reducing minority stress. At the end 1-2 cm higher. Once the first stage is well healed (around a month) the session, participants will: patient starts electrolysis or laser in the area where both of the 1. Identify psychosocial factors that impact identity development urethras will be connected. When we are sure that there is no hair and interpersonal relationships regrowth (3months), we do a 45 min surgery under spinal or general 2. Acquire essentials for developing and conducting a gender- anesthesia to connect both of the urethras in a double-breasted affirming intake closure technique. 3. Identify how and when client ambivalence emerges and ways to Results: The rates of stenosis and fistula have gone down approach ambivalence tremendously since connecting the urethra in a separate surgery. More analysis of our numbers is needed to give specific percentages. Surgery Updates / Chirurgies: mise à jour Conclusion: Finding ways to diminish urethral complications is the main concern with phalloplasty surgery nowadays. 11F. Monarch - La plateforme du changement (Présentation orale) 17E. Improving the Radial Forearm Flap Donor Site in a Single-Stage Procedure: Presenters: The Use of Acellular Dermal Matrix Daphney Prophète, Infirmière clinicienne, Ordre des and Skin Grafting (Oral Presentation) infirmières du Québec, Montreal, Quebec Henri Labelle, Travailleur Social et Psychothérapeute, Presenter: Ordre des Travailleurs Sociaux du Québec, Ordre des Dr. Maud Belanger, FRCSC, Plastic Surgery, GRS Montréal, Psychologues du Québec, Montreal, Quebec Montreal, Quebec

GrS Montréal a développé une plateforme web permettant à ses Purpose: Radial forearm flap is the most commonly chosen type of patients de participer plus activement au processus menant à la phalloplasty for various reasons. The donor site is thin and supple chirurgie. De la constitution du dossier préopératoire, aux soins et allowing the flap to be easily tubed and shaped into a penis and the enseignements postopératoires, cette plateforme innovante offrira skin provides good erogenous sensation. The radial forearm donor de suivre en direct l’avancement du dossier, de communiquer avec site can be closed using a split thickness skin graft harvested from les professionnels de GrS Montréal, de s’informer sur les soins pré the thigh. The major complaint of the radial forearm flap when used et postopératoires et de visionner des vidéos d’enseignement. La for phalloplasty is that the donor site gives a stigmatizing scar that is plateforme Monarch est unique au monde et représente le désir de difficult to conceal. Finding ways of improving the radial forearm GrS Montréal de constamment améliorer la qualité de ses services. flap donor site in a single stage procedure with the use of acellular dermal matrix and skin grafting is the main goal of this procedure. ______

53 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

9:30 - 9:45 am BREAK Foyer Salle de Bal 9h45 - 11h15 am ATELIER Presenter: Dr. Asa Radix, MD, MPH, MPhil, FACP Location: Ballroom Centre Thank you to Our CPATH Sunday Break Sponsor WPATH SOC8 MIS À JOUR - L’amélioration des soins pour des clients 9:45 - 11:15 am WORKSHOP transgenres et non binaires (Simultaneous Translation) Presenter: Dr. Asa Radix, MD, MPH, MPhil, FACP L’Association mondiale des professionnels en santé transgenre Location: Ballroom Centre (WPATH) est une association professionnelle, internationale et multidisciplinaire dont la mission est de promouvoir le soin WPATH SOC8 UPDATE - basé sur des preuves, l’éducation et la recherche, ainsi que des Advancing Care for Transgender and éléments pédagogiques et politiques, orientés vers le respect de Gender Non-Binary Clients (Traduction simultanée) la santé des personnes transgenres. WPATH est surtout connu pour la publication Standards de Soins (SDS) publiées pour la The World Professional Association for Transgender Health première fois en 1979. Grâce aux directeurs de WPATH, les SDS (WPATH) is an international, multidisciplinary, professional sont maintenant à leur 7e révision. Les SDS sont basés sur les association, whose mission is to promote evidence-based care, données scientifiques disponibles à ce jour et les consensus education, research, advocacy, public policy, and respect for d’experts. WPATH a traduit les SDS7 en 17 langues, qui peuvent transgender health. WPATH is best known for publishing the être télécharger gratuitement sur www.wpath.org. Le processus Standards of Care (SOC) first published in 1979. Through de révision des SDS8 est en cours présentement et le WPATH WPATH’s leadership, the Standards of Care is now in its 7th s’attend à publier la première ébauche au début de 2020 pour revision. The Standards of Care is based on evidence-based commentaires. Ce symposium présentera un aperçu du processus medicine and expert professional consensus. WPATH has d’élaboration des recommandations, recueillera les commentaires translated the SOC7 into 17 languages all available free for de l’auditoire et fournira des options pour commentaires download via www.wpath.org. The revision process for SOC8 is supplémentaires. currently underway and WPATH is expected to release the first draft for feedback in early 2020. This symposium will present an Présentateur : overview of the process for developing the recommendations and Dr. Asa Radix est le directeur principal de gather input from the audience as well as provide mechanisms for recherche et d’éducation et professeure further feedback. agrégée de médecine clinique à l’Université de New York. Dr Radix a suivi une formation Presenter: en médecine interne et en maladies Dr. Asa Radix is the Senior Director of infectieuses à l’Université du Connecticut Research and Education and a Clinical et a obtenu un diplôme de troisième cycle Associate Professor of Medicine at New en médecine tropicale et en santé publique au Royaume-Uni. Dr York University. Dr. Radix trained in Radix est un expert reconnu en médecine transgenre qui a plus de internal medicine and infectious diseases 20 ans d’expérience dans la prestation de soins primaires et dans at the University of Connecticut and l’administration de l’hormonothérapie aux personnes transgenres completed postgraduate qualifications et non binaires. Dr Radix est présentement coprésident du comité in tropical medicine and public health de révision des Standards de Soins de l’Association mondiale des in the United Kingdom. Dr. Radix has professionnels en santé transgenre (WPATH) et siège aux conseils over 20 years of experience providing primary care and hormone d’administration de WPATH et USPATH. Dr Radix est rédacteur therapy to transgender and gender non-binary people and is a en chef adjoint de Transgender Health et membre du comité de recognized expert in transgender medicine. Dr. Radix is currently rédaction de l’International Journal of Transgenderism. co-chair of the World Professional Association of Transgender Health (WPATH) Standards of Care revision committee and serves on the WPATH and USPATH boards. Dr. Radix is Associate 11:15 - 11:30 am BREAK Foyer Salle de Bal editor of Transgender Health and on the editorial board for the International Journal of Transgenderism.

Thank you to Our CPATH Sunday Break Sponsor

54 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

11:30 am - 1:00 pm PLENARY (EN) Dr. Maud Bélanger received her medical degree in 2005 from Université Laval in (Traduction simultanée) Quebec City and completed her plastic surgery Moderators: residency in 2010 at Université de Montréal. Françoise Susset Afterwards, she pursued her fellowship in Lorraine Grieves ! microsurgery and breast reconstructive surgery at the renowned Ghent University Hospital QUEBEC - Dr. Pierre Brassard, Dr. Maud Bélanger in Belgium.Dr. Bélanger previously practised BC - Dr Alex Kavanagh, Dr. Krista Genoway at the Hôtel-Dieu de St-Jérôme Hospital before devoting herself ONTARIO - Dr. Yonah Krakowsky entirely to private practice at the Centre Métropolitain de Chirurgie. Location: Ballroom Centre British Columbia Gender Affirming Surgeries: Dr. Alex Kavanagh is a reconstructive urologist certified by the Royal College of Increasing Accessibility Across Canada Physicians and Surgeons of Canada. He Surgeons from Quebec, BC and Ontario will gather and share completed medical school at the University updates about Gender Affirming Surgeries and the developments of Calgary and a Master of Public Health at that are increasing accessibility across Canada. Harvard University. His urologic residency was completed at UBC, and he has since Moderators: completed a fellowship in female pelvic Françoise Susset is a clinical psychologist and couple and family medicine and reconstructive surgery in Houston, as well as therapist. Her current focus is working with gender diverse a fellowship in male urethral and pelvic reconstruction with children, youth and their families, and helping schools challenge Dr. Sanjay Kulkarni. Dr. Kavanagh has also completed visiting notions regarding sexuality, sexual orientation, gender identity fellowships at several centres of excellence in gender- affirming and gender expression. Françoise is responsible for the training surgery, including Crane and Brownstein Surgical (Drs. Curtis and clinical supervision of a great number of clinicians across Crane and Richard Santucci), Dr Mang Chen (Bunke Clinic, San Canada wishing to integrate transgender health in their practice. Francisco), the New York Langone School of Medicine (Dr. Lee She teaches in the McGill University M.A. program in Couple Zhao) and Mount Sinai Hospital (Dr. Ting). and Family therapy. Françoise is past president of the Canadian Dr. Krista Genoway - is a board-certified Professional Association for Transgender Health (CPATH). plastic and reconstructive surgeon based in Lorraine Grieves is a registered clinical counsellor and active Vancouver, BC. She completed her medical member of the British Columbia Association of Clinical school and residency training in plastic and Counsellors. She has a Master’s degree in Counselling Psychology reconstructive surgery at the University of and has been practicing as a helping professional since the early British Columbia. She then completed a 1990’s in a diverse range of roles and programs. fellowship in reconstructive microsurgery with a sub-specialty focus on providing gender- Panelists: affirming surgical care in San Francisco, California. Quebec Dr. Genoway began offering upper surgery in 2016 and lower Dr. Pierre Brassard received his medical surgery in 2019. She is a clinical instructor in the Department degree from Université Laval in 1985, of Surgery at UBC and is active medical staff within Vancouver graduating first in his class and with honours. Coastal Health. Four years later, he received his degree Ontario in plastic surgery from the Université de Dr. Yonah Krakowsky is a proud graduate Montréal and went on to sub-specialize of the University of Toronto urology program in microsurgery at Hôpital Maisonneuve- and returned as faculty last year at Women’s Rosemont and the renowned Mayo Clinic in College Hospital and Mount Sinai Hospital. Minnesota. From 1990 to 1996, Dr. Brassard practised as a surgeon He is the medical lead of the Transition and teacher at the Hôtel-Dieu de Québec Hospital and the Hôtel- Related Surgery (TRS) program at Women’s Dieu de Lévis Hospital. He became a member of the Department College Hospital and the Assistant Program of Plastic Surgery at the Hôtel-Dieu de St-Jérôme Hospital in 1996 Director of the Urology residency program. and served as Chief of the Department from 1998 to 2000. Since

2000, Dr. Brassard has been devoted entirely to private practice and is the Medical Director and, since 2006, sole owner of the Centre Métropolitain de Chirurgie.

55 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

11h30 am - 13h00 pm PLÉNIER (EN) Dr. Maud Bélanger a obtenu son diplôme (Simultaneous Translation) de médecine en 2005 de l’Université Laval à Québec et a complété sa résidence en chirurgie Modérateurs: plastique en 2010 à l’Université de Montréal. Par Françoise Susset la suite, elle a poursuivi une bourse scolaire en

! Lorraine Grieves microchirurgie et chirurgie reconstructive du sein à l’Hôpital Universitaire de Gand en Belgique. Dre QUÉBEC - Dr. Pierre Brassard, Dr. Maud Bélanger Bélanger a pratiqué à l’Hôtel-Dieu de St-Jérôme BC - Dr Alex Kavanagh, Dr. Krista Genoway avant de se consacrer entièrement à la pratique privée au Centre ONTARIO - Dr. Yonah Krakowsky Métropolitain de Chirurgie. Location: Ballroom Centre British Columbia Chirurgies d’affirmation de genre accroître Dr. Alex Kavanagh est un urologue spécialist l’accessibilité à travers le Canada en chirurgie reconstructative certifié par le Collège royal des médecins et chirurgiens Des chirurgiens du Québec, de la Colombie-Britannique et de du Canada. Il a fait ses études de médecine l’Ontario partageront des mises à jour sur les chirurgies d’affirmation à l’Université de Calgary et obtenu une du genre et sur les développements qui augmentent l’accessibilité maîtrise en santé publique à l’Université des soins de l’affirmation de genre partout au Canada. Harvard. Sa résidence en urologie a été complétée à l’Université du Colombie- Modérateurs: Britannique, et il a par la suite complété une bourse de recherche en Françoise Susset est psychologue clinicienne et thérapeute de médecine pelvienne féminine et chirurgie reconstructive à Houston, couple et de famille. Son travaille courant est axé sur les enfants, ainsi qu’une bourse de recherche en reconstruction urétrale et les jeunes et à leur famille et sur la remise en question des pelvienne chez l’homme avec Dr Sanjay Kulkarni. Dr Kavanagh a notions de sexualité, d’orientation sexuelle, d’identité sexuelle et également été boursier invité dans plusieurs centres prestigieux de d’expression sexuelle dans les écoles. Françoise est responsable chirurgie d’affirmation du genre, notamment les centres de Crane de la formation et de la supervision clinique d’un grand nombre de et Brownstein Surgical (Dr Curtis Crane et Dr Richard Santucci), Dr cliniciens canadiens autour du pays, qui souhaitent intégrer la santé Mang Chen (Bunke Clinic, San Francisco), New York Langone School transgenre dans leur pratique. Elle enseigne à l’Université McGill of Medicine (Dr Lee Zhao) et Mount Sinai Hospital (Dr Ting). pour le programme de maîtrise en thérapie de couple et de famille. Françoise est l’ancienne présidente de l’Association professionnelle Dr. Krista Genoway - Dre Krista Genoway est canadienne pour la santé des transgenres (CPATH). une chirurgienne plasticienne et reconstructive certifiée , basée à Vancouver, en Colombie- Lorraine Grieves est conseillère clinique agréée et membre actif Britannique. Elle a terminé ses études de de la British Columbia Association of Clinical Counsellors. Elle est médecine et sa résidence en chirurgie plastique titulaire d’une maîtrise en psychologie du counseling et, depuis et reconstructive à l’Université de la Colombie- le début des années 1990, elle travaille comme intervenante Britannique. Elle a ensuite complété un professionnelle dans une variété de rôles et de programmes. fellowship en microchirurgie reconstructive avec Panélistes: une sous-spécialisation dans la prestation de soins d’affirmation de genre chirurgicale à San Francisco, Californie. Dre Genoway a Québec commencé à offrir la chirurgie thoracique en 2016 et la chirurgie Dr. Pierre Brassard a obtenu son diplôme génitale en 2019. Elle est instructrice clinique au département de de médecine de l’Université Laval en 1985, chirurgie de l’Université de la Colombie-Britannique et fait partie du où il a terminé premier de sa promotion et service médical actif de Vancouver Coastal Health. avec distinction. Quatre ans plus tard, il a obtenu son diplôme en chirurgie plastique Ontario à l’Université de Montréal et s’est spécialisé Dr. Yonah Krakowsky is a proud graduate of en microchirurgie à l’Hôpital Maisonneuve- the University of Toronto urology program and Rosemont et à la célèbre clinique Mayo returned as faculty last year at Women’s College au Minnesota. De 1990 à 1996, Dr Brassard a pratiqué comme Hospital and Mount Sinai Hospital. He is the chirurgien et professeur à l’Hôtel-Dieu de Québec et à l’Hôtel-Dieu medical lead of the Transition Related Surgery de Lévis. Il est devenu membre du Service de chirurgie plastique (TRS) program at Women’s College Hospital and de l’Hôpital Hôtel-Dieu de St-Jérôme en 1996 et en a été le chef du the Assistant Program Director of the Urology département de 1998 à 2000. Depuis 2000, Dr Brassard se consacre residency program. French to come entièrement à la pratique privée—il est directeur médical et, depuis 2006, propriétaire unique du Centre Métropolitain de Chirurgie. ______56 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

1:00 pm THANK YOU, CLOSING Dr. Michael Marshall, CPATH President-Elect

CONFERENCE CLOSING Ceremonial Closing - Charlie Patton

57 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

CPATH 2019 Poster Sessions

AUTHORS PRESENT Friday, November 1, 2019 1:30-2:00 pm Saturday, November 2, 2019 1:30-2:00 pm

1F. Enfants créatifs dans le genre : mieux 42E. Do Parental and Clinical Support Matter comprendre les défis du couple parental for the Health of Transgender and et de la famille pour mieux les soutenir Gender Diverse Children and Youth?: A Systematic Review Présentateurs : Karine Nadeau-Paquette, intervenante en santé mentale à la Presenters: Maison Jacques-Ferron, Université du Québec à Montréal, Anne-Marie Parent, Master’s student, McGill University, UQAM, Montréal, Québec Montréal, Québec

Introduction et objectifs : Dans l’optique d’identifier les facteurs Co-presenters: favorisant le bien-être des enfants trans et créatifs dans leur Tracy Wong, PhD student, McGill University, Montréal, Québec genre, plusieurs éléments ont été identifiés. Actuellement, le Chiaki Konishi, Assistant Professor, McGill University soutien familial, l’accès aux interventions transaffirmatives et Montréal, Québec la possibilité de vivre en sécurité à l’école sont les facteurs de Although there is a common understanding that strong support protection les plus reconnus pour leur bien-être. Dans cette is critical for the well-being and mental health of transgender and présentation, nous mettrons l’accent sur le soutien parental et gender diverse youth (e.g., Simons, Schrager, Clark, Belzer, & les connaissances actuelles sur l’adaptation des familles et des Olson, 2013; Travers et al., 2012), there is currently no systematic couples parentaux. review that addresses how parent and clinician support are Méthode et échantillonnage : Nous avons recensé, dans la associated with transgender and gender diverse children and documentation scientifique publiée en anglais et en français, 16 youth outcomes. articles sur l’expérience parentale au sein des familles ayant un Hence, the main objective of the present systematic review was enfant créatif dans le genre. Cette recension porte sur les années to explore and document the differential constructs related to 2002 à 2018 et a été réalisée à l’aide de la base de données parent and clinician support such as acceptance, connectedness, PsycINFO, de moteurs de recherche tels que Google Scholar et and affirmation, as well as non-supportive behaviors such as de la liste de références des articles consultés. rejection, harassment, discrimination, and violence. Indeed, we Résultats et discussion : Les études se sont essentiellement were interested in exploring how parent and clinician support concentrées sur les parents qui soutiennent leur enfant et sur les were associated with various physical health and mental health répercussions psychologiques de la transphobie et du manque outcomes for transgender and gender diverse children and youth de services spécialisés. Quelques études qualitatives font état de under the age of 18, inclusively. Study design was informed by conflits au sein du couple parental, notamment de désaccords area expert consultations and pilot searches. Eligibility criteria quant aux pratiques transaffirmatives et face à l’expression de were established to include: (1) all original research of quantitative genre de l’enfant. Cependant, aucune étude n’en propose une or mixed-methods design; (2) self-reports of transgender and analyse approfondie. gender diverse participants and/or their parents’, and clinicians’ Recommandations : Dans la perspective d’accompagner self-reports; and (3) publications in English peerreviewed journals. adéquatement les familles avec des enfants trans ou créatifs A complex electronic search strategy was developed to obtain a dans leur genre, une étude approfondie des défis qui émergent broad range of results from four databases relevant to our study au sein du couple parental et de la famille est nécessaire. Il faut topic: PsycINFO, MEDLINE, Scopus, and socINDEX. A total of mieux comprendre comment peuvent se concilier des points 4,665 citations were considered for the review, according to the de vue différents entre parents et leurs répercussions sur le inclusion criteria. After deduplication and assessing for exclusion développement de l’enfant. Il faut, enfin, mieux saisir comment criteria, a resulting 12 papers were included in the analysis. le couple, mais aussi la famille, s’adapte et fait sens de la The present project will identify gaps in the current literature on créativité de genre de l’enfant. parent and clinician support of transgender and gender diverse children and youth and provide information and recommendations that will inform the practice of policymakers, social workers, psychologists, and community organizations, as well as families of transgender and gender diverse children and youth.

58 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

69E. Environmental Scan of Transgender and 70E. Trans Youth Capacity to Consent Gender Diverse Patient Navigator Programs for Hormone Therapy: The Evidence in North America and the Ethics

Presenter: Presenter: Emily Boughner, PhD Student, Saskatchewan Health Dr. Beth Clark, The University of British Columbia, Vancouver, Authority, Saskatoon, Saskatchewan British, Columbia

Co-presenters: Co-presenter: Dr. Megan Clark, CCFP, Family Medicine Physician, Dr. Alice Virani, British Columbia Provincial Health Services Saskatoon, Saskatchewan Authority, Vancouver, British, Columbia Dr. Michelle McCarron, PhD, Saskatchewan Health Authority, Clinical, ethical, and legal decisions about youth capacity, Saskatoon, Saskatchewan rights, and authority to consent for hormone therapy are often Objective: Saskatchewan currently lacks an established patient contentious. In Canada, youth usually have the legal authority navigator for trans and gender diverse (TGD) individuals that to consent to their own health care when they demonstrate the could help address barriers faced by the TGD community by capacity to do so, in accordance with the mature minor doctrine or linking patients to community supports and helping patients specific provincial or territorial legislation. navigate the healthcare system. The objective of the current However, practices of honouring youth consent for hormone project is to explore established patient navigator programs therapy vary. While there exists a body of literature regarding youth to help inform the development of a patient navigator for TGD capacity to consent to health care, including empirical studies, individuals within Saskatchewan, in collaboration with the scholarship on youth consent for gender-affirming care has been Saskatchewan Trans Health Coalition. largely theoretical. This study was an empirical investigation of Methods: An environmental scan of TGD patient navigators minor youth capacity to give consent for hormone therapy, using within North America is currently being conducted. Patient conventional content analysis of interviews with 47 participants navigators are contacted by phone or email to engage in an from British Columbia, Canada (21 trans youth, 15 parents interview to determine such indicators and outcomes as the of trans youth, and 11 health care providers offering hormone parameters of the role, qualifications, location, and how readiness assessments/care planning for trans youth). The results outcomes of patient navigator use are determined. Additionally, were consistent with the empirical and theoretical literature and a literature review of patient navigators within North America contribute empirical support for trans youth capacity to consent and Western Europe is being conducted to supplement the for hormone therapy, based on demonstration of the generally environmental scan. accepted elements of capacity evaluation: understanding of Preliminary findings: The data-gathering process is currently relevant information; appreciation of this information in the context ongoing. Preliminary findings suggest that British Columbia, of one’s own life; reasoning about treatment options; and Alberta, Ontario, and Nova Scotia have established patient ability communicate a clear choice that is consistent with one’s navigators for TGD populations, some within regional or values. An empirical ethical analysis drawing on both deontological provincial health authorities and some with independent and consequentialist reasoning gives further support for both organizations. When the navigator is associated with a health the right and the legal authority of trans youth to give consent authority, the navigator generally tends to have a professional for hormone therapy. The learning objectives of this poster designation (e.g., registered social worker or nurse). presentation include development of: a greater understanding Anticipated conclusions and future directions: The goal of this of the elements of capacity evaluation; evidence regarding youth project is to explore current patient navigator positions for TGD capacity to consent for hormone therapy; and ethical arguments in individuals in order to reduce barriers and increase access to support of the right and legal authority for capable trans youth to healthcare. As TGD individuals often have difficulty navigating provide consent for hormone therapy. the healthcare system, the development of a patient navigator within Saskatchewan will be meeting an identified need within the province.

59 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

71E. Assessment of Knowledge, Attitudes 73E. Developing an Online Curriculum and Skills Working with Transgender on Trans Affirming Post-Sexual Assault Clients of Saskatchewan Family Physicians, Care for Professionals Working Within Family Medicine Residents and Nurse Healthcare Settings Practitioners Presenter: Presenter: Janice Du Mont, Senior Scientist, Research Institute of Dr. Megan Clark, University of Saskatchewan Department of Women’s College Hospital and Professor of Public Health Family Medicine, Saskatoon, Saskatchewan at the University of Toronto, Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario Co-presenters: Presenting Author: Emily Boughner, Ms., Saskatchewan Health Authority Joseph Friedman Burley Research Department, Saskatoon, Saskatchewan Authorship List: Krishia McLaren, Dr., University of Saskatchewan Department Miljanovski, M.; Saad, M.; Friedman Burley, J.; MacFarlane, of Family Medicine, Saskatoon, Saskatchewan D., Macdonald, S; & Du Mont, J. Lisette Christopherson, Dr., University of Saskatchewan Department of Family Medicine, Saskatoon, Saskatchewan Background: Trans populations experience exceptionally high rates of sexual victimization (Grant et al., 2011; Gentlewarrior Objective: In Spring 2019, we intend to distribute a survey to & Fountain, 2009). One in five (20%) trans Ontarians report all family physicians, nurse practitioners and family medicine experiencing lifetime physical or sexual assault specifically residents in Saskatchewan. This survey will assess the because of their trans identity (Bauer & Scheim, 2015).Despite participants’ knowledge, attitudes and skills with regards to the importance of receiving sensitive and informed post-sexual working with trans and gender diverse (TGD) patients. Our assault care, trans persons across Ontario frequently experience objective is to identify any potential knowledge, skill, stigma and discrimination and avoid seeking care in health or attitude gaps in these participants. The survey has been care settings (Bauer et al., 2014; Bauer et al., 2009; Davies developed by our research team and has been reviewed by the & Hudson, 2011; munson & Cook-Daniels, 2016). To address Saskatchewan Trans Health Coalition, which consists of trans this gap, Women’s College Research Institute, Women’s College and gender diverse people, service organization representatives Hospital is collaborating with the Ontario Network of Sexual and healthcare providers. Assault/Domestic Violence Treatment Centers (SA/DVTCs) Methods: Participants will be recruited through their respective and Rainbow Health Ontario to adapt an in-person training on professional organizations and the University of Saskatchewan providing trans-affirming care for sexual assault survivors to an family medicine residency program. The survey will be created accessible, e-learning curriculum that will be made available to and collected online using REDCap. Analyses will include a professionals providing post-sexual assault care in healthcare comparison between family medicine residents in Regina, SK settings across Ontario. Online education has been found to (who may have additional training in trans health given the be an effective as a platform for remote delivery of professional enhanced learning opportunities available at the site) education and in improving the knowledge and self-efficacy of and residents from other sites. Comparisons between family healthcare professionals (Ally, 2008; Sinclair et al., 2016). medicine residents, nurse practitioners, and practicing family Methods: The e-learning curriculum is being developed using physicians will also be done and descriptive statistics will be Storyline 360 by Articulate, an award-winning software for the produced. Paired samples t-tests and ANOVAs will be used to design of interactive courses, and guided by evidence-based analyse continuous data. Chi-square tests will be used to analyse Principles of Multimedia Learning (Mayer, 2008). It will be dichotomous data. reviewed by a Community Reference Group comprising relevant Anticipated conclusions and future directions: As trans and sources of community-based expertise in trans health gender diverse patients often report suboptimal quality of care and violence. when interacting with healthcare providers, this project aims Evaluation: The curriculum’s efficacy will be evaluated to to utilize its findings to inform development of an educational determine improvements in level of knowledge, perceived program. The goal of this program is to expand practitioners’ competence, and actual competence on core competencies knowledge, skills and attitudes when working with related to trans-affirming care in the post-sexual assault context trans and gender diverse clients to provide this patient population pre- and post-training. Using a comprehensive knowledge with better care in Saskatchewan. We hope our survey will help translation plan, we will disseminate information about the direct educational initiatives of current and future family doctors online curriculum and its evaluation among relevant academic, and nurse practitioners in this province. Given Saskatchewan’s government, and community stakeholders. geographical dispersion, it is imperative that education and support for practitioners in rural and remote communities be made available. 60 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

74E. Building an Intersectoral Network on 75E. A First Step to Increasing Community Trans-Affirming Practice to Support Capacity in Working with Gender Diverse Sexual Assault Survivors Children and Youth: A Needs Assessment of Community Physicians Presenters: Janice Du Mont, Senior Scientist, Research Institute of Presenter: Women’s College Hospital and Professor of Public Health Dr. Natalie Finner, Adolescent Medicine Subspecialty at the University of Toronto, Women’s College Research Resident at BC Children’s Hospital in Vancouver, Institute, Women’s College Hospital, Toronto, Ontario Children’s Hospital of Eastern Ontario, Ottawa, Ontario Presenting Author: Joseph Friedman Burley Purpose: To explore training, confidence and comfort levels of Authorship List: community care providers in managing pediatric gender diverse Miljanovski, M.; Saad, M.; Friedman Burley, J.; MacFarlane, patients. To assess their willingness to participate in a care model D., Macdonald, S; & Du Mont, J. that is collaborative with a tertiary centre. Preferred strategies for education and support were solicited. Background: Trans persons experience high rates of sexual Methods: A one point survey solicited pediatricians and family assault, have limited access to health services, and may have physicians who had referred patients to a Gender Diversity unique needs post-victimization (Bauer & Scheim, 2015; clinic situated within a Canadian tertiary care pediatric hospital. munson & Cook-Daniels, 2016). Sexual assault against trans A questionnaire was developed to measure: demographics; persons is a complex issue, globally recognized to require previous exposure to pediatric gender diversity; training; current increased intersectoral collaboration to improve service delivery knowledge and comfort level in the management of pediatric (Lo & Horton, 2016). In addressing this need, Women’s College gender diversity; and, willingness to increase their involvement. Research Institute, Women’s College Hospital, in collaboration Results – 105 physicians were eligible to participate. Though 66 with the Ontario Network of Sexual Assault/Domestic Violence agreed to participate, 25 completed the questionnaire. Very few Treatment Centres (SA/DVTCs) and Egale Canada have had had training; 72% stated they would like to increase their undertaken a project to bring together local transpositive confidence and expertise in working with this population; 64% community organizations with program managers of the 35 responded that with the right support they would be interested SA/DVTCs across Ontario in 7 regional Knowledge Mobilization in collaborating to provide care to their pediatric gender diverse and Community Engagement (KM-CE) meetings. patients. Objective: The goal of the KM-CE meetings is to lead to the Conclusions: Lack of training and a high level of discomfort establishment of a permanent, province-wide Intersectoral prevents community physicians from providing care to gender Network on Trans-Affirming Practice to Support Sexual Assault diverse children and youth. Most respondents however were Survivors. This Network will ensure that trans survivors of amenable to the skill training and support options that provide sexual assault are offered up-to-date, appropriate, and sensitive the confidence prerequisite to their collaboration in the care across Ontario. Methods: The process of developing and management of these young people. consolidating the Network will be guided by the Lifecycle Model for Guiding Network Development as outlined by the National Collaborating Centre for Methods and Tools (NCCMT), which includes sequential stages for planning, forming, maturing, and sustaining a network (Robeson, 2009). Outcomes: The newly formed Network will be consolidated by co-developing and sharing tangible resources, such as: a terms of reference, an internal report on priorities to guide future research and practice in this area, a communications plan to articulate and promote the purpose and value of network, and an online service directory of participating organizations. The development of these resources, and the process of planning and forming the Network, will be shared amongst a target audience of service providers, government decision-makers, and researchers.

61 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

76E. Navigating Un(familiar) Terrain: 77E. Cervical Cancer Screening in Trans Experiences of Adolescent Siblings and Gender Non Binary Persons of Transgender Youth – Patient and Provider Perspectives on Barriers to Screening and Presenter: Eli Godwin, MEd, Study coordinator and a data analyst for the Strategies for Quality Improvement

Trans Teen and Family Narratives Project, Presenter: Boston Children’s Hospital, Boston, Massachusetts Suza Hranilovic, Primary Health Care Nurse Practitioner, St. Co-presenter: Michael’s Hospital Academic Family Health Team, College L.B. Moore, MEd, Boston Children’s Hospital, Boston GLASS, of Nurses of Ontario, Toronto Boston, Massachusetts Rates of cervical cancer screening are significantly lower for While recent research has begun to address the effects of family trans men and gender non binary persons. Research suggests support on transgender and gender nonconforming (TGN) youth, that reasons for this phenomenon are multiple and nuanced. In few studies have examined the effects of the TGN youth’s transition this quality improvement project, we reviewed current literature process on the family system as a whole. The scant literature that to understand strategies for improving cervical cancer screening has included siblings of TGN people nearly universally includes rates in this population. We then interviewed both patients and only adult siblings positioned as as controls. To date, no peer- providers in our clinic in an effort to understand how we might best reviewed studies have directly queried adolescent siblings of TGN apply this information to our practice setting. Our qualitative data youth about their own experiences and support needs is presented with accompanying reflection about how providers As part of the Trans Teen and Family Narratives Project, a might more effectively approach cervical cancer screening for trans communitybased sample of 33 families (33 TGN youth ages 13-17 and gender non binary patients. Our results emphasize the patient years, 48 caregivers, and 15 siblings ages 13+) was recruited perspective and include a summary of anonymized patient from the New England region of the United States. Participants stories and suggestions. We build on data from previous quality completed in-person qualitative interviews and surveys at five improvement projects in our practice setting that confirm waves in 6-month intervals. Interviews were audio-recorded disparities in cancer screening rates amongst our patient and professionally transcribed. For the current study, 15 sibling population, even when adjusting for other variables, in order to interview transcripts from baseline were analyzed using immersion/ advocate for more equitable screening in this patient population. crystallization and thematic analysis. Analyses yielded three prominent themes: familiarity with, awareness of, and knowledge about transness (“FAKTs”) as mediators of sibling responses; assessing responses of others to their TGN sibling (“relational terrain”), and experiences unique to siblings of TGN youth. Within these themes, multiple subthemes were also identified; for example, siblings assessed responses to the TGN sibling with respect to their own social standing (“courtesy stigma”) and the social, emotional, and physical wellbeing of their sibling. Our findings indicate the need to engage with siblings of TGN youth directly to further elucidate their intra-familial, extra-familial, and intrapersonal experiences related to their TGN sibling and determine their unique support needs.

62 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

78E. Gender Diversity Clinic at a 79E. Using the ECHO Model to Help Tertiary Care Pediatric Centre Increase Confidence and Competency - After the Launch in Providing Gender-Affirming Primary Care

Presenter: Presenter: Dr. Natasha Johnson, Pediatrician, Adolescent Medicine Carrie Lawford, BSW, MSW, RSW, Social Worker in the Adult Specialist, Department of Pediatrics at McMaster Gender Clinic at the Centre for Addiction and Mental University, McMaster Children’s Hospital, Health (CAMH), Toronto, Ontario Hamilton, Ontario Co-presenter: Christina Yager, MSW, RSW, Social Worker in the Adult Children and youth from our region were being sent to another Gender Clinic at the Centre for Addictions and Mental tertiary care centre for gender affirming care. Recognizing the Health (CAMH), Toronto, Ontario need to provide care closer to home, a group of clinicians came Cathy Maser, Nurse Practitioner, Division of Adolescent together to provide services at our own teriary centre. The core Medicine, Team Lead, Transgender Youth Clinic, The group of clinicians consists of an Adolescent Medicine Specialist Hospital for Sick Children, Toronto (who is also a pediatrician), a Pediatric Endocrinologist, a Speech Language Pathologist (SLP), and Social Workers. Other ECHO Ontario Trans and Gender Diverse Healthcare (ECHO TGDH) specialists are involved as needed (Gynecology, Registered aims to helps to increase confidence in primary care providers by Dietician, Psychiatry). The number of children and youth providing a trans-affirming space for healthcare providers to learn referred to us has grown exponentially and our wait list has from one another about medical transition, which is shifting service grown. Partnerships with community providers and resources provision from the CAMH Gender Identity Clinic to providers has been invaluable. Routine assessment by SLP with supporting clients towards gender-affirming surgeries in their own opportunity to do voice coaching is a unique service offered practice. in our clinic. Our poster describes the services offered, Learning Objectives: demographics of the patients seen and identified co-morbidities. 1. Describe the ECHO model, gaps in healthcare delivery proposed solutions. 2. Demonstrate how technology can be leveraged to increase collaboration and capacity in supporting clients towards gender- affirming surgeries. 3. Summarize the key findings from the ECHO (TGDH) program evaluation.

Background: Primary care providers (PCP) play an integral role in access to transitionrelated care for trans and gender expansive persons. Professional development outreach can support care provision, though equitable access remains challenging. The ECHO (Extension of Community Health outcomes) model was implemented through a multi-clinic partnership (CAMH, Sick Kids Hospital, and Sherbourne Health). Multipoint videoconferencing created a community of practice with PCPs and allied health to share knowledge and build capacity with transition-related care delivery (HRT, surgical referral, and mental health support) closer to home. Objective: ECHO Ontario Transgender and Gender Diverse Healthcare (TGDH) recruited 41 PCPs and allied health professionals from 20 organizations across Ontario. The curriculum was based on needs assessment and expert consensus. ECHO was delivered via Zoom technology. Didactic and casebased presentations from peers were used. We report on two cycles of ECHO, respectively. Methods: Pre and post surveys, measuring changes in providers’ selfefficacy in providing transition-related care and knowledge acquisition of current best practices. Weekly data on provider

63 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA consistently high across all domains (professional isolation, of hormone therapy and preparations in the Gender Program are enhanced knowledge, and learning needs). Perceived self- in line with current guideline recommendations. This will allow for efficacy increased significantly after participation in the program comparison in metabolic outcomes, and hormone complication (p<0.001), with a trend towards an increase in knowledge. rates with other reported cohorts while identifying unique Canadian Discussion/Impact: High participant satisfaction and increased population characteristics. self-efficacy with transitionrelated care suggests the ECHO model is a useful tool in both reaching primary care on a provincial level 82E. Demographics of the and contributing to equity in access to services. University of Alberta Gender Program: Setting up a Cohort 81E. Hormone Therapy Use and Prescription Practices for the First Year of the Presenter: Dr. Anna Rogers, Clinical Endocrinologist with the Division University of Alberta Gender Program of Endocrinology and Metabolism at the University Presenter: of Alberta and Division of Endocrinology Lead for the Dr. Anna Rogers, Clinical Endocrinologist with the Division Gender Program., University of Alberta Gender Program, of Endocrinology and Metabolism at the University Edmonton, Alberta of Alberta and Division of Endocrinology Lead for the Co-presenters: Gender Program., University of Alberta Gender Program, Adam Mullen, Medical Student at University of Alberta, Edmonton, Alberta Edmonton, Alberta Co-presenters: Dr. Michael Marshall, Psychiatrist at University of Alberta, Adam Mullen, Medical Student at University of Alberta, Edmonton, Alberta Edmonton, Alberta While there has been emerging data on the demographics of Dr. Michael Marshall, Psychiatrist at University of Alberta, the Gender Diverse population in other centres, the population Edmonton, Alberta in Alberta has not yet been described. The Gender Program at The University of Alberta Gender Program is a multidisciplinary the University of Alberta was borne out of the need to create a clinic for Gender Diverse children and adults. It facilitates cohesive, collaborative and multidisciplinary approach to provide collaboration via seamless referral between psychiatry, psychology, affirming care for gender diverse children and adults. Data has nursing, adult and pediatric endocrinology and urological and been extracted from the electronic medical record system. gynecological surgical specialties. Patient demographics, and A total of 107 persons have been seen by psychiatry and adult hormone therapy statistics for the first 11.5 months of the Gender endocrinology in the first 11.5 months of the Gender Program. Program have been collected. 107 Gender Diverse individuals 42.06% (45 persons) are 18-24 years of age, 29.91% (32 persons) have been assessed by adult endocrinology. 72% (77 persons) are 25-29 and 14.95% (16) are 30-34. In terms of geographic are between 18-29 years of age. 46% (50 persons) identify as location, 77.6% (83) were located in the Edmonton Zone, 14.95% Transmale (affirmed gender is male with female sex assigned at (16) in the North Zone, and 6.54% (7) in the Central Zone. With birth) 43% (47) identify as Transfemale (female affirmed gender respect to gender identity, 46.73% (50) identified as Transmale, with male sex assigned at birth), and 9.3% (10) identify as non- 43.93% (47) identified as Transfemale, and 9.35% (10) identified binary. Hormone therapy was initiated by 88.8% (95 persons) as non-binary. The proportion of gender non-binary persons is within the first endocrinology assessment. 1.8% (2) remained notably lower than in the 2015 US Transgender Survey in which undecided about the start of hormone therapy following their 31% of their respondents identified as gender non-binary. 38 total first visit. For feminizing therapy, spironolactone is the most surgery referrals were made on behalf of 31 different persons (7 common anti-androgen used by 44 persons, with 2 persons using patients with >1 referral). Mastectomy was the most common cyproterone acetate. Of the 45 persons taking estradiol, 61.7% surgical referral comprising 68.24% (26 Total; 21 Transmale, 5 (29) are using oral estradiol, 15.9% (17) are using transdermal Gender Non-binary) of total referrals. 13.16% (5 Transmale) have estradiol, and 1 person is using IM estradiol valerate. 1 person is been referred for hysterectomy. No one has been referred for using only estradiol and progesterone and 6 are using estradiol, phalloplasty or metoidoplasty. 5 referrals for vaginoplasty progesterone and spironolactone. For masculinizing therapy, 47 were made on behalf of 4 Transfemales. Expressed interest in any persons are using testosterone with 38 % (18) using subcutaneous surgical referral by affirmed gender was also captured within the testosterone injection, 23.4% (11) using intramuscular testosterone first 3-4 appointments. 15 patients have had voice referrals for and 14.8% (7) using a transdermal preparation due to needle voice feminization therapy (14 Transfemale, 1 Gender Non-binary). phobia. 9 of the 10 people who identified as non- binary are Continuing to capture the demographics and evolving needs of using testosterone. Hormone regimens are standard with a higher the gender diverse population in Alberta will allow for comparisons proportion of transmasculine persons using weekly sub-cutaneous across time, between other Canadian cohorts, and ultimately testosterone injections instead of intra-muscular. Statistics for use ensure the Gender Program is best able to serve the Gender Diverse community appropriately.

64 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

83E. Does Age Matter? Mental Health 84E. Training HCPs and Learners about Implications and Determinants of Transgender Surgical Needs: When Youth Present to a Gender Clinic An Evaluation of Capacity Building

Presenter: Presenter: Dr. Julia Sorbara, Staff Endocrinologist at the Hospital for Sick Dr. Thea Weisdorf, MD, Assistant Professor University Children, The Hospital for Sick Children, Toronto, Ontario of Toronto, Family Physician at St. Michael’s Hospital Academic Family Health Team, Faculty Development Lead Background/Aims: Gender incongruent youth experience high DFCM SMH, St. Michael’s Hospital Toronto, University of rates of mental health comorbidities. We hypothesized that youth Toronto, Toronto, Ontario presenting to our clinic later in age are more distressed than their younger peers and that identifiable barriers may have delayed their Co-presenters: clinic attendance. Sue Hranilovic, Nurse Practioner, St. Michael’s Hospital, Methods: Charts of new patients to the SickKids Transgender Toronto, Ontario Youth Clinic (TYC) were reviewed for details of the gender history In Ontario, prior to March 1 2016, transgender and gender and indicators of psychological distress. Subjects were classified as non-binary individuals were required to attend the Centre for younger presenting youth (YPY): <15 years of age at presentation Addiction and Mental Health’s (CAMH) Gender Identity clinic to be or older presenting youth (OPY): > 15 years of age. Factors assessed for appropriateness for Transition Related Surgery (TRS). influencing age at presentation to care were explored through 24 After this date, “qualified providers” became eligible to provide semi-structured interviews with OPY, YPY, and their caregivers. this assessment. At the St. Michael’s Hospital Academic Family Thematic analysis of transcripts was performed. Health Team (SMHAFHT) where a wide spectrum of health care is Results: Of 300 patients, 184 (61%) were OPY (mean age: 16.23 provided to over 500 transgender and non-binary patients, many + 0.70 years, mean Tanner stage [TS]: 4.47 + 0.52) while 116 providers felt this training would be essential and affirming (39%) were YPY (mean age: 13.59 + 1.05 years, mean TS: 3.88 in supporting their transitions. Based on the Rainbow Health + 0.89). Upon TYC presentation, significantly more OPY than Ontario (RHO) competency training which the authors had YPY reported a diagnosis of depression (46% vs 30% p=0.006), undertaken (one of whom herself is a RHO trainer), an initial were using psychoactive medications (36% vs 23%, p =0.017), competency training workshop was held in March and April 2018 experienced suicidal ideation (52% vs 40%, p=0.034), had self- over two half days. The level of knowledge, skills and confidence harmed (40% vs 28%, p=0.022) and had attempted suicide (17% gained among participants was extremely high (and statistically vs 9%, p=0.033). 11 themes were identified from interviews significant). In March 2019, a second competency workshop that influenced age at first clinic visit. YPY had a more streamlined was undertaken with more than twice the number of health care referral process while OPY tended to see multiple physicians prior providers (HCP) participating than the year before and once to TYC referral. OPY/caregivers described more religious and family again, the knowledge, skills and confidence gained was tensions related to gender nonconformity while YPY/caregivers tremendous and significant. Qualitative data from participant described a sense of urgency for medical treatment. evaluations extracted predominant themes of the training, Conclusions: Upon presentation to a gender clinic, OPY have leading to suggestions for future training workshops to further higher rates of psychological distress and appear to have faced raise the experience for the providers. Ultimately we believe more barriers accessing care than YPY. Quantitative follow-up of this will enhance the care all HCPs at SMHAFHT provide to our differences identified in qualitative interviewing is ongoing. These transgender and gender non-binary patients. data may help to identify modifiable factors that impact access to care and outcomes.

65 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

85E. Help-Seeking Initiatives and Perceptions 107E. Exploring Patterns and Defects of Service Accessibility by Transgender in Referrals to the Transition Related People Who Have Experienced Intimate Surgery Program at Women’s College Partner Abuse: A Systematic Review Hospital

Presenter: Presenter: Jessica Whitehead, Masters of Social Work candidate at Emery Potter, Nurse Practitioner, Transition Related Surgery McGill University, a member of the McGill’s Centre for Program, Women’s College Hospital, Toronto, Ontario Research on Children and Families, and a Research Co-presenters: Associate with the Centre for Social and Legal Responses Lindsay Reddeman, MD-MSc candidate, University of to Violence, McGill University, School of Social Work, Toronto, Toronto, Ontario Montréal, Québec The WCH TRS program is the first publicly administered publicly Co-presenters: funded TRS program in Canada. The program began in early Dr. Zack Marshall, Assistant Professor, School of Social Work, 2018 with the intent to increase access to transition related McGill University, Montréal, Québec surgeries. This program began at a time of a shifting landscape Dr. Katherine Maurer, Assistant Professor, School of Social of care, where patients no longer required CAMH approvals for Work, McGill University, Montréal, Québec surgery and could be approved for OHIP covered surgeries by a Katie Tilley, MSW Candidate, School of Social Work, McGill medical doctor or nurse practitioner. This resulted is a learning University, Montréal, Québec gap for providers who were new to making referrals for surgery. Recent findings suggest that transgender people may experience Much work has been done by individual organizations and higher rates of partner abuse (e.g. Langenderfer-Magruder, provincial organizations such as RHO to educate providers on Whitfield, Walls, Kattari, & Ramos, 2016). It has also been making appropriate and thorough assessments for surgery. established that transgender people may experience additional This quality improvement initiative was undertaken to evaluate personal and social barriers to reporting abuse. A structured the quality of referrals from the new landscape of providers in search of intimate partner abuse occurring between LGBTQ+ Ontario. In this analysis we looked at both descriptive statistics partners in January 2019 produced 1,718 references. After and a defect analysis to evaluate the quality of referrals. From deduplication, 1,076 were screened on title and abstract this analysis, we can gain helpful insights into what future and 339 were reviewed on full text. 43 of references met education and support is required for both patients and referring the inclusion criteria because 12 of these studies included providers. transgender people, we decided to conduct a focused analysis of this literature. Our systematic review aimed to determine commonalities in what happened after transgender individuals, who were able to overcome these personal barriers, sought support. We will discuss common themes regarding who transgender people have reached out to for services, where they have sought formal support, when services have been rejected by the organization, when services have been offered, and how this contact has been perceived when offered or rejected. References: Langenderfer-Magruder, L., Whitfield, D. L., Walls, N. E., Kattari, S. K., & Ramos, D. (2016). Experiences of intimate partner violence and subsequent police reporting among lesbian, gay, bisexual, transgender, and queer adults in Colorado: Comparing rates of cisgender and transgender victimization. Journal of interpersonal violence, 31(5), 855-871.

66 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

108F. Résultats de l’enquête en ligne menée au Québec sur la santé sexuelle, mentale, physique et affective des hommes trans ayant des relations avec d’autres hommes

Presenter: Étienne Chamberland, Agent de projet de recherche – Hommes trans, RÉZO, Montréal, Quebec Co-presenter: Samuel Bonnefont, Coordonnateur Web et Réseaux sociaux et Coordinateur du projet Hommes trans, RÉZO, Montréal, Quebec

Ce projet de recherche vise à mettre en lumière les besoins spécifiques des hommes trans gai, bi et HARSAH en matière de santé sexuelle et plus généralement de santé globale ainsi que les services offert et/ou utilisé pour cette population. Depuis quelque année, plusieurs changements dans la loi ont favorisé l’accès aux services, mais les besoins sont encore grands, notamment en matière de santé sexuelle et de santé mentale et dans l’accès a des services respectueux et ouvert à la diversité de genre. Nous avons réalisé une enquête en ligne qui a rejoint plus de soixante-dix hommes trans gai, bi et HARSAH au Québec. Les questions portaient sur la santé sexuelle, mentale, physique et affective des hommes trans ainsi que les services utilisés par ceux-ci. Ce sont ces résultats ainsi que quelques pistes de solutions que nous aimerions vous présenter sur une affiche.

67 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

CPATH Speaker Bios A

Noah Adams, MSW is a social worker, researcher, and Literary & Cultural Disability Studies; Canadian Journal of Disability activist based in Toronto, Ontario, and a co-founder of TPATH - the Studies; Disability & Society; Somatechnics; Genre, sexualité & Transgender Professional Association for Transgender Health. société; Recherches féministes; Enfances, familles, générations: He currently works for the City of Toronto’s shelter system and Revue internationale; Revue Jeunes et Société; Criminologie; volunteers his time with Rainbow Railroad, the Gay/Bi/Queer Trans Philosophiques and Recherches sociologiques & anthropologiques. Mens Working Group, on various projects with WPATH, among other His intersectional research places gender, feminist, queer, trans, things. He received a Bachelor of Arts (majoring in Psychology), and disability/crip studies in dialogue with the sociology of the from the University of British Columbia in 2004, a Bachelor of Social body, health and social movements. His recent research examines Work from the University of Victoria in 2009, and a Masters of Social discourses on suicide and assisted suicide within anti-oppressive Work from Dalhousie University in 2015. PhD Student, Activist, movements/studies. Ontario Institute for Studies in Education. Alex Baril, Ph.D. en études des femmes, est professeur adjoint Ronnie Ali (they/them/their) is a Registered Psychotherapist à l’École de service social de l’Université d’Ottawa et spécialiste de (Qualifying) with the College of Registered Psychotherapists of la diversité, incluant la diversité sexuelle et de genre, corporelle Ontario. They passionately work to support and advocate for folks (handicaps et santé) et linguistique. La formation interdisciplinaire who live intersectional lives (queer/trans, BIPOC, neurodivergent, d’Alexandre Baril combine dix années en philosophie/éthique, living with disabilities) by offering therapeutic services, building un doctorat en études des femmes, ainsi que deux stages community, and providing consultation. postdoctoraux en études féministes, des genres et des sexualités à Wesleyan University (Bourse postdoctorale du Conseil de recherches Jamie Anderson holds a Bachelor of Education and is en sciences humaines du Canada/CRSH) et en science politique à currently completing his Master of Arts in Educational Research Dalhousie University (Bourse postdoctorale Izaak Walton Killam). Il a specializing in Curriculum and Learning. Jamie’s research focuses publié plusieurs articles dans des revues telles que Hypatia: Journal on queer and trans experiences in education. Over his seven years of Feminist Philosophy; Feminist Review; TSQ: Transgender Studies in the classroom, Jamie worked to support his students by making Quarterly; Atlantis: Critical Studies in Gender, Culture & Social lessons inclusive, acting as the GSA sponsor teacher, and founding Justice; Frontiers: A Journal of Women Studies; Annual Review the Foothills GSA Network. He is also a member of the Alberta of Critical Psychology; Medicine Anthropology Theory; Journal of Teacher’s Association Diversity Equity and Human Rights committee, Literary & Cultural Disability Studies; Canadian Journal of Disability and most recently began a volunteer position with Alberta Health Studies; Disability & Society; Somatechnics; Genre, sexualité & Services on the Sexual Orientation, Gender Identity and Expression société; Recherches féministes; Enfances, familles, générations: (SOGIE) Provincial Advisory Council. Revue internationale; Revue Jeunes et Société; Criminologie; Philosophiques et Recherches sociologiques & anthropologiques. Ses recherches intersectionnelles se situent à la croisée des études B de genre, queer, trans, du handicap et de la sociologie du corps, de la santé et des mouvements sociaux. Ses travaux récents se Alex Baril, Ph.D. in Women’s Studies, is an Assistant Professor penchent sur les discours tenus sur le suicide et le suicide assisté at the School of Social Work at the University of Ottawa, specializing au sein des mouvements et des études anti-oppression. in diversity, including sexual, gender, (dis)ability, and linguistic diversity. Alexandre Baril’s interdisciplinary training combines ten Robert Bartlett, M.S.W., is a clinical therapist with over 20 years in philosophy/ethics, a Ph.D. in Women’s Studies and two years experience working with youth and families. He is a member postdoctoral fellowships in Feminist, Gender, and Sexuality Studies of the IWK Trans Health and School Mental Health teams. Robert at Wesleyan University (Social Sciences and Humanities Research facilitates and organises the Youth Speak talk in the annual Trans Council/SSHRC Postdoctoral Fellowship), and in Political Science at Health Symposium, sits on the clinician panel and is an active peer Dalhousie University (Izaak Walton Killam Postdoctoral Fellowship). supervisor in the monthly provincial child and youth health provider He has published articles in journals such as Hypatia: Journal of network sessions. He has a passion for breaking down barriers that Feminist Philosophy; Feminist Review; TSQ: Transgender Studies teens and their families face in accessing care. Quarterly; Atlantis: Critical Studies in Gender, Culture & Social Justice; Frontiers: A Journal of Women Studies; Annual Review of Critical Psychology; Medicine Anthropology Theory; Journal of

68 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Dr. Greta Bauer is a professor in Epidemiology and Nolan Blodgett, MSW, is a trans-identified clinical social Biostatistics at Western University, and the Principal Investigator worker based in Toronto, Ontario. Raised in a rural Northern on the Trans Youth CAN! project. Dr. Bauer is a leader in health Ontario community, Nolan is passionate about bridging the health research focusing on LGBT communities, and study methodologies gap for LGBTQ2S folks between rural, remote, and northern vs. for hidden or marginalized populations. For over 20 years she has urban communities. Currently, Nolan practices psychotherapy at conducted research in LGBT health, and has led several long-terms Church Wellesley Counselling & Psychotherapy with a focus on projects.These included the Trans PULSE survey, where she wrote trauma- informed work with trans and gender diverse folks. Prior the first published research on trans patient access to primary and to completing their clinical training, Nolan has been engaged in emergency care, and did significant work in identifying intervenable community organizing and research with an emphasis on rural trans factors for suicide prevention. Her work has contributed to significant health across multiple Ontario communities for over 6 years. Nolan advances in human rights policy in Canada, as well as advances in is the first author on a recent publication, “Overcoming the Barriers research on LGBT health. in Transgender Healthcare in Rural Ontario: Discourses of Personal Agency, Resilience, and Empowerment”, an exploratory qualitative Antoine Beaudoin Gentes Chargé de projet depuis study which captured the lived experiences of trans and non-binary septembre 2018 chez Enfants transgenres Canada (Gender Creative folks in navigating the health care system in rural Ontario. Kids Canada), Antoine Beaudoin Gentes est un militant queer qui luttent pour les droits LGBTQ+ et qui travaille activement à la Vincent Bolt uses he/him/il pronouns. He is a registered social défense des droits et au soutien des enfants transgenres et non worker, and in 2018 graduated with a Bachelor of Indigenous Social binaires et leurs familles au Québec. Il collabore également avec Work from Laurentian University. He is from Sudbury Ontario, and le CHU Sainte-Justine au programme Espace Transition qui offre is passionate about providing services that empower the trans des ateliers d’art à des adolescent.e.s qui terminent un processus community in Northern Ontario. He has been doing public speaking d’hospitalisation en santé mentale. e interdisciplinaire queer et since 2006, and presents to over 2,000 people every year. When he féministe projets hybris qui réalise des spectacles, des performances is not on the road, he likes to spend his time at home with his rabbit, et des événements engagés et politiques à Montréal. Winter.

Antoine Beaudoin Gente is the project coordinator Samuel Bonnefont est Coordonnateur web et réseaux for Gender Creative Kids Canada, a Montreal-based community sociaux à RÉZO, où il co-coordonne également le projet Hommes organization that actively support, equip and protect transgender, trans (HoT). Franco-canadien souvent à vélo, Samuel aime le non-binary, gender creative children and their families. He is also the cinéma, les voyages et le soccer, et il est titulaire d’un Master en artistic supervisor of the Espace Transition program at CHU Sainte- Design & Multimédia interactifs ainsi qu’en Esthétique & Cinéma de Justine where he pursues his involvement that aims to promote l’Université Paris I (Panthéon-Sorbonne). Engagé, il s’est d’abord the inclusion of stigmatized youth in our society. Trained as a impliqué, en France, à Greenpeace et Act Up-Paris, avant de professional actor, he co-directs the queer and feminist art collective cofonder un organisme par et pour les personnes trans (OUTrans, projets hybris with whom he participates in various productions on en 2008). Il s’intéresse particulièrement aux enjeux de prévention / stage and in public spaces. santé sexuelle pour les gars trans HARSAH, et il a d’ailleurs travaillé sur le premier Guide français de prévention pour les gars trans et Dr. Maud Bélanger, received her medical degree in 2005 leurs amant-e-s (DTC, 2010), des ateliers de discussions gars cis from Université Laval in Quebec City and completed her plastic / gars trans, ainsi que sur un portail web dédié aux enjeux trans surgery residency in 2010 at Université de Montréal. Afterwards, she et VIH. Au Québec, son engagement l’a amené à s’impliquer sur pursued her fellowship in microsurgery and breast reconstructive différentes thématiques : Droits & Visibilité, Prévention & Santé, surgery at the renowned Ghent University Hospital in Belgium. Urbanité & Écologie, et Sports LGBT+. Dr. Bélanger previously practised at the Hôtel-Dieu de St-Jérôme Hospital before devoting herself entirely to private practice at the Samuel Bonnefont is a web and social media coordinator at Centre Métropolitain de Chirurgie. REZO, where he also co-coordinates the Trans Men (HoT) project. Samuel is a proud French Canadian who loves riding his bike, going Dr. Maud Bélanger, a obtenu son diplôme de médecine en to the cinema, traveling and playing soccer. He holds a master’s 2005 de l’Université Laval à Québec et a complété sa résidence en degree in Interactive Design & Multimedia as well as Esthetics & chirurgie plastique en 2010 à l’Université de Montréal. Par la suite, Cinema from the University of Paris I (Pantheon-Sorbonne). Being elle a poursuivi une bourse scolaire en microchirurgie et chirurgie engaged in his field, his first foray was with Greenpeace and Act reconstructive du sein à l’Hôpital Universitaire de Gand en Belgique. Up in Paris, France before he went on to cofound an organization Dre Bélanger a pratiqué à l’Hôtel-Dieu de St-Jérôme avant de se by and for trans people-OUTrans, in 2008. He is especially focused consacrer entièrement à la pratique privée au Centre Métropolitain on preventative and sexual health issues for trans guys HARSAH. de Chirurgie. Samuel has worked on the first French preventative health guide for trans guys and their lovers (DTC, 2010), discussion workshops cis

69 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA guys / trans guys, as well as on a web portal dedicated to trans and Morag Bosum, is a candidate for a master’s degree in sexology HIV issues. In Quebec, his commitment has led him to get involved in research at the University of Quebec in Montreal, Morag Bosom different areas: Rights & Visibility, Prevention & Health, Urbanism & specializes in gender issues, particularly health and education Ecology, and LGBT+ Sports. related to gender diversity. After collaborating with numerous student organizations and student associations for gender diversity for her Heather Bonnell (she/her) is a graduate from Acadia thesis, she questions the role of cisgender researchers and how to University’s BSNutrition program and is a Dietetic Practicum student, become an effective ally. Her research work focuses on access to a member of the LGBTQ+ community, and proud member of Acadia health care and inequities related to gender diversity, to improve the Pride. She worked in theatre for 10 years before returning to university. training of health professionals practicing with the trans community. From watching friends and community members transition, she felt that there was more that health care professionals could do to support Morag Bosum Candidate à la maîtrise en recherche en gender variant individuals. She has been working with Cath Morley sexologie, à l’Université du Québec à Montréal, Morag Bosom se on community-engaged research with the gender variant community spécialise sur les questions de genre, en particulier la santé et with Acadia Pride. At the time of the CPATH conference, she will be a l’éducation concernant la diversité de genre. Après avoir collaboré student in the Acadia Dietetic Practicum program. avec de nombreux organismes et associations étudiantes pour personnes issues de la diversité de genre dans le cadre de son Isabelle Borduas est sexologue psychothérapeute dans mémoire, elle se questionne sur la place des chercheur.res cisgenres la région de la Mauricie et du Centre-du-Québec. Son approche et comment devenir un.e allié.es efficace. Son travail en recherche se théorique est éclectique, bien qu’elle s’inscrive principalement concentre sur l’accès aux soins de santé et les inégalités en lien avec dans le courant cognitivo-comportemental et humaniste-existentiel la diversité de genre, afin améliorer la formation des professionnels de la psychologie. Entre 2003 et 2015, elle a travaillé en tant que de la santé pratiquant avec la communauté trans. sexologue au Cégep de Trois-Rivières et y a créé le groupe l’ACCÈS, un groupe de discussion et de soutien pour les personnes LGBTQA+. Gabrielle Bouchard est présidente de la Fédération des Elle a fondé le réseau des Alliées de la Mauricie-Centre- du-Québec femmes du Québec. Elle siègait jusqu’au déclenchement des élection en collaboration avec l’organisme Sidaction de Trois- Rivières qui au Conseil consultatif sur la stratégie pour prévenir et contrer la est aujourd’hui sous la responsabilité de l’organisme GRIS Mauricie- violence fondée sur le sexe. Co-lauréate du prix Héméris 2015 du Centre-du-Québec. Depuis 2015, elle pratique en clinique privée à Conseil québécois LGBT Bouchard a travaillé comme défenseure Trois-Rivières et à Nicolet, où elle reçoit entre autres des personnes des droits trans et éducatrice publique au Centre de lutte contre trans, des membres de la famille immédiate ou des proches de l’oppression des genres de 2011 à 2017. Elle a été la porte-parole personnes trans. Elle est actuellement candidate à la maîtrise en du Centre dans sa poursuite contre le gouvernement québécois pour sexologie profil recherche-intervention, et s’intéresse au vécu des mettre fin aux discriminations faites envers les personnes trans, non- femmes cisgenres en couple avec un homme trans, dans une région binaires et intersexes dans la province. Elle a participé au processus située hors des grands centre urbains. Elle est aussi conférencière menant aux changements législatifs pour mettre fin à la stérilisation auprès des institutions ou groupes communautaires qui en font la forcée des personnes trans au Québec. Elle est titulaire d”un demande, sur les sujets qui touchent la sexualité humaine. certificat en justice réparatrice de Simon Fraser. Bouchard enseigne également le tai-chi au Tai Chi Club de Montréal. Chui Lap Kan. Isabelle Borduas is a sexologist and psychotherapist in the Mauricie and Centre-du-Quebec region. Her theoretical approach Gabrielle Bouchard is President of the Quebec Women’s is eclectic, although it is mainly part of the cognitive-behavioural Federation. She was a member until the elections were called of and humanistic-existential stream of psychology. Between 2003 the Advisory Council on the Strategy to Prevent and Respond to and 2015, she worked as a sexologist at the Cegep de Trois-Rivieres Gender-based Violence. Co-winner of the 2015 Héméris Prize of and created the ACCES group, a discussion and support group the Conseil québécois LGBT, she worked as a trans rights defender for LGBTQA+ people. She founded the network of the Allies of the and public educator at the Centre for gender advocacy from 2011 to Mauricie-Centre du-Quebec in collaboration with the Sid-action 2017. She was the Centre’s spokesperson in its lawsuit against the organization in Trois-Rivieres, which is now under the direction of the Quebec government to end discrimination against trans, non-binary GRIS Mauricie- Centre-du-Quebec organization. Since 2015, she has and intersex people in the province. She was involved in the process been practicing in private clinics in Trois-Rivieres and Nicolet, where leading to legislative changes to end the forced sterilization of trans she provides services to trans people, immediate family members and people in Quebec. She holds a certificate in restorative justice from relatives of trans people, among others. She is currently a candidate Simon Fraser. Bouchard also teaches tai chi at the Tai Chi Club in for a master’s degree in sexology with a research-intervention Montreal Chui Lap Kan. profile and is interested in the experience of cissexual women in a relationship with a trans man, residing in areas outside the major urban centres. She is also a conference speaker on topics that affect human sexuality for institutions and community groups upon request.

70 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Emily Boughner is a second year doctoral student in clinical Dr. Pierre Brassard received his medical degree from psychology at the University of Regina in Regina, Saskatchewan. Université Laval in 1985, graduating first in his class and with She is interested in engaging with research involving the social honours. Four years later, he received his degree in plastic surgery context and health of individuals who may have experienced from the Université de Montréal and went on to sub-specialize in traumatic events or have otherwise had negative interactions with microsurgery at Hôpital Maisonneuve-Rosemont and the renowned organizations or institutions, such as the healthcare system. Her Mayo Clinic in Minnesota. From 1990 to 1996, Dr. Brassard research generally focuses on experiences of trauma and betrayal practised as a surgeon and teacher at the Hôtel-Dieu de Québec within institutions, such as universities or workplaces. Hospital and the Hôtel-Dieu de Lévis Hospital. He became a member of the Department of Plastic Surgery at the Hôtel-Dieu de Maude Bourgeois-Turcotte Psychologue offrant des St-Jérôme Hospital in 1996 and served as Chief of the Department services enfants, ado, adultes en diversité de genre. Membre from 1998 to 2000. Since 2000, Dr. Brassard has been devoted CPATH Administratrice au conseil d’administration de l’organisme entirely to private practice and is the Medical Director and, since TRANS-Mauricie/Centre-du-Québec. 2006, sole owner of the Centre Métropolitain de Chirurgie.

Maude Bourgeois-Turcotte is a psychologist offering Julie Brassolotto, PhD is an Assistant Professor in the Public gender diversity services for children, teenagers and adults. Maud Health Program in the Faculty of Health Sciences at the University of is a member of the CPATH Board of Directors of TRANSMauricie/ Lethbridge, who holds an Alberta Innovates Health Solutions (AIHS) Centre-du-Quebec. Research Chair in Rural Health and Well-being.

Dr. Amy Bourns, is a family physician who has been Ligaya Byrch is a community innovator and entrepreneur. As a community innovator, Ms. Byrch has focused over 32 years as a providing comprehensive primary care to transgender patients Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) organizer. since 2012 as a part of the multidisciplinary LGBTQ2S team at After working almost 30 years in the health sector Ligaya has chosen Sherbourne Health in Toronto, ON. Dr. Bourns began to build to focus her time on family and things that bring her joy and inevitably her knowledge of trans health through the completion of the first change the world for the better. For the Ted X Orillia 2019 Ligaya LGBTQ2S Enhanced Skills Residency Program in Canada following focused on her work within the transgender communities. Ligaya family medicine residency. Since that time, she has been involved was the recipient of the Woman of the Year Award as awarded by the in expanding the capacity of health care providers in caring for then LGBT Community Council of Windsor for her work with LGBTQ transgender patients and has contributed her expertise to the youth. In 2016, Ligaya’s work and contributions to the community development of recommendations for cancer screening and sexual were recognized by Simcoe Pride as she was the recipient of the health in trans populations. Dr. Bourns has authored two revisions of Honorary Award for Activism and Leadership. Ligaya also hosted two Sherbourne Health’s Guidelines for Gender-affirming Primary Care award winning radio programs, LesBiQ Airwaves and Queer Radio. for Trans and Non- binary Patients, the most recent having been Ligaya continues to support the LGBTQ community locally as she sits on the OSMH LGBTQ Committee and the Trans Health Services released in the spring of 2019. Dr. Bourns also takes an avid interest Steering Committee located at the Couchiching Family Health Team. in medical education and is currently the Program Director for the Most recently, Ms Byrch was one of many authors in the publication, LGBTQ2S Enhanced Skills Residency Program with the University of “Queering Social Work Education.” Toronto’s Department of Family and Community Medicine.

Dr. Pierre Brassard a obtenu son diplôme de médecine de C l’Université Laval en 1985, où il a terminé premier de sa promotion et avec distinction. Quatre ans plus tard, il a obtenu son diplôme en Étienne Chamberland est agent de projet de recherche chirurgie plastique à l’Université de Montréal et s’est spécialisé en pour le projet sur les hommes trans qui aiment les hommes à RÉZO. microchirurgie à l’Hôpital Maisonneuve-Rosemont et à la célèbre Il possède plusieurs compétences en termes d’implication socio- clinique Mayo au Minnesota. De 1990 à 1996, Dr Brassard a pratiqué professionnel et en termes de savoir expérientiel. En effet, c’est un comme chirurgien et professeur à l’Hôtel-Dieu de Québec et à l’Hôtel- conférencier, formateur, animateur et aussi intervenant. Il détient une Dieu de Lévis. Il est devenu membre du Service de chirurgie plastique expérience de près de 10 ans en intégration sociale par l’entremise de l’Hôpital Hôtel-Dieu de St-Jérôme en 1996 et en a été le chef du de l’art tout en passant par une implication dévouée à l’ADDICQ département de 1998 à 2000. Depuis 2000, Dr Brassard se consacre (Association pour la défense des droits et l’inclusion des personnes qui consomme des drogues au Québec). Étienne s’identifie comme entièrement à la pratique privée—il est directeur médical et, depuis une personne trans depuis maintenant 4 ans. 2006, propriétaire unique du Centre Métropolitain de Chirurgie. Étienne Chamberland est agent de projet de recherche pour le projet sur les hommes trans qui aiment les hommes à RÉZO. Il possède plusieurs compétence

71 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Étienne Chamberland is a research project officer for the multidisciplinary gender diversity clinic at CHU Sainte-Justine, as well trans men who love men project in REZO. He has many competencies as setting up the multidisciplinary team for the care of children with related to his social and professional involvement and experiential DSD. knowledge. He is a conference speaker, trainer, facilitator and panelist. He has nearly 10 years of experience in social integration through art, Lisette Christopherson is a first year family medicine as well as a dedicated involvement with ADDICQ (Association pour resident in Regina, Saskatchewan. She was born and raised in la défense des droits et l’inclusion des personnes qui consomme Saskatchewan and hopes to remain here to provide primary health des drogues au Québec-association for the defence of the rights and care. She hopes to provide comprehensive medical care to trans and inclusion of people who use drugs in Quebec). Etienne has identified gender diverse patients in her future practice. as a trans person for 4 years now. Beth Clark, PhD, HEC-C, RCC, is a postdoctoral fellow whose research focuses on clinical ethics and health equity. Beth completed Ace Chan is a community-based public health researcher with a PhD in Interdisciplinary Studies at the University of British Columbia an interest in cancer prevention and decreasing health disparities in (2018), with a dissertation on ethical and health care decision-making sexual and gender minority communities. surrounding initiation of hormone therapy for trans youth. While in Vancouver, Beth worked for several years with Trans Care BC, the Caitlin Chee (artist name Babia Majora) is a trans non-binary Trans Health Information Program, and the Stigma and Resilience mixed-race artist and activist who seeks to dismantle gender on stage Among Vulnerable Youth Centre, and also volunteered with the and in everyday life. Living life in the margins, the in between, they Catherine White Holman Wellness Centre. Beth now holds the Allen- blur lines between social constructs of the masculine and feminine. Berenson Fellowship in Women’s, Gender, and Sexuality Studies at Through their work as a Collective member and support worker for Brandeis University in Boston, with a program of research focused the Toronto Rape Crisis Centre/Multicultural Women Against Rape on bioethics, health care provider education, and promoting health they work towards a violence-free world. They seek to support their equity in trans communities. In addition to being a Registered Clinical trans and non-binary community through activism and education and Counsellor (RCC) in BC, Beth is a certified health care ethicist (HEC-C) co-produce and host F*ck Sh*t UP; Toronto’s only monthly trans and in the US, and has completed advanced training in pediatric bioethics non-binary cabaret at the Gladstone Hotel. You can also see them at Mercy Children’s Hospital in Kansas City. Beth has published on performing and challenging gender norms on stages across North ethics and trans health topics in CMAJ, the International Journal of America as Babia Majora, as a part of Toronto’s all trans and gender Transgenderism, and Family Practice, and presented research at past nonconforming Drag haus Rebel Gen, and as a member of Canada’s WPATH and CPATH conferences. first BIPOC centred burlesque troupe, Les Femmes Fatales: Women of Colour Burlesque Troupe.

Megan Clark, MD, CCFP is a family physician in Regina, Lyne Chiniara Dr Chiniara est diplomée de l’Université de Saskatchewan. She has almost 50 trans and gender diverse clients Montréal où elle a complété son doctorat en médecine en 2008, puis in her practice, for whom she provides surgical referrals, hormone sa surspécialité en endocrinologie pédiatrique en 2013. Elle a effectué therapy and gender affirming general family medicine care. She teaches une formation complémentaire au Hospital for Sick Children à Toronto University of Saskatchewan medical students and family medicine en différences de développement du sexe (DSD) et en diversité de residents at the Regina Family Medicine Unit academic clinic. She is genre. Elle est candidate à la maitrise en pédagogie des sciences proud to participate in the Saskatchewan Trans Health Coalition. médicales à l’Université de Montréal. Elle est professeure adjointe de clinique au département de pédiatrie de la Faculté de Médecine de l’Université de Montréal et pratique au CHU Sainte-Justine en D tant qu’endocrinologie pédiatrique. Ses intérêts de recherche et d’enseignement portent sur les DSD et sur la dysphorie de genre en pédiatrie. Dr Chiniara travaille activement à la mise en place de la Marie de la Cheneliere Femme transgenre de 67 ans à clinique multidisciplinaire de diversité de genre au CHU Sainte-Justine, la retraite. Experte d’expérience bénévole auprès de la Maison Dispersée ainsi que la mise en place de l’équipe multidisciplinaire pour la prise de Santé pour les personnes en interrogation de genre et/ou en début de en charge des enfants avec DSD. transition. Chercheuse associée auprès du Centre Collaborateur de l’OMS à Lille en France pour l’étude sur le diagnostic d’incongruence de Lyne Chiniara Dr. Chiniara graduated from the University of genre dans le cadre de la révision de CIM 10 en CIM 11. Montreal where she completed her MD in 2008, and her subspecialty in pediatric endocrinology in 2013. She completed additional training Marie de la Cheneliere is a 67-year-old transgender woman at the Hospital for Sick Children in Toronto in difference in sex who is retired. She is an experienced and expert volunteer at the development ( DSD) and in gender diversity. She is a candidate for Maison Dispersée de Santé for gender questioning people and/or in a Master’s degree in Pedagogy of Medical Sciences at the Université the early stages of transition. Marie is also an associate researcher at de Montréal. She is Assistant Clinical Professor in the Department of the WHO Collaborating Centre in Lille, France for the ICD 10 to ICD 11 Pediatrics of the Faculty of Medicine at the Université de Montréal revisionary study on the diagnosis of gender incongruity. and practices at CHU Sainte-Justine as pediatric endocrinology. Her research and teaching interests include DSD and pediatric gender dysphoria. Dr. Chiniara is actively working on the establishment of the 72 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Jillian Demontigny MD is a family physician with The Taber S J Drake Psy.D. is a nonbinary trans person living and working Medical clinic, in Taber, Alberta, who provides primary health care to in Vancouver, BC, on unceded Coast Salish land. In research and many transgender and gender non-conforming people in rural Southern practice, they are passionate about addressing gender, social Alberta. determinants of health and wellness, and collaborative approaches to public health issues, particularly for youth with nondominant identities. Maude Desrochers Maude Desrochers (pronouns: she, Drake has brought values of trans visibility and inclusion and facilitated her) is a sexologist, couple and family therapist and psychotherapist access to resources through program development, consultation, from Quebec. She graduated from Université du Québec à Montréal and education initiatives in their graduate training at Adler University, (UQÀM) in 2014 and from McGill University in 2019. While completing working in youth shelters, and through clinical training in Texas. her internship at McGill University Sexual Identity Centre (MUSIC), she participated in creating and facilitating a group for parents of Janice Du Mont is a Senior Scientist at the Research Institute transgender and gender questioning youth. Maude mostly worked, in of Women’s College Hospital and Professor of Public Health at the her native town, at community centres and at her private practice with University of Toronto, where she is also Director of the Collaborative victims of sexual abuses, sexual offenders and LGBTQ+ community. Specialization in Women’s Health. Her research focuses on improving As one of the rare professional working with LGBTQ+ community in the care provided to diverse survivors of sexual assault, intimate partner Joliette, she decided to be socially involved. Maude is now working with violence, and elder abuse. the town’s administration to establish more inclusive practices at local organizations. She is also a new board member for the youth centre of her town, La Maison des Jeunes du Grand Joliette. F As Maude really wants to make a difference in Quebec’s society, she got involved in a couple of jobs to learn more about research. She steven feder coordinated a research in a community centre about child victims of Graduated McGill Medical School 1976 sexual abuses in partnership with UQÀM and Martine Hébert. She Canadian College of Family Physicians 1979 University of Western also translated a research’s report in partnership with the Social Work Ontario Faculty of Calgary University. In her free time, Maude travels around MPH Maternal and Child health University of Minnesota 1991 the world or spends time on her little farm. She got her passion for Clinical Fellowship, University of Minnesota 1991 animals from her family. What a lucky girl she is, her boyfriend and Associate Professor University of Ottawa her step-family are crazy animal lovers too. Maude fairly believes in zootherapy: three Great Danes are now a part of her life (and her bed)! Chief Division of Adolescent Medicine, Children’s Hospital of Eastern One of them also helps her to create a therapeutic alliance with some of Ontario (CHEO) her clientele in private practice. Co-Director Diversity Clinic CHEO Clinical endeavours: Gender Diversity and Eating Disorders Natasha Dionne est une travailleuse sociale clinique. Elle a étudié en psychologie (bac), en art-thérapie (DESS) et en travail social Gavrel Feldman BA, is an Ashkenazi, genderfluid, transsexual (maîtrise) et elle poursuit actuellement son doctorat, en travail social, à la settler. They have been doing Queer and Trans support and advocacy première chaire canadienne de recherche sur les enfants transgenres et work for over 10 years with a specific focus on trans-affirming health leur famille à l’Université de Montréal. Elle consacre principalement ses care access, community self-determination, youth-empowerment and études sur les besoins des parents afin de contribuer à développer les intergeneration connections. She currently sits on the Trans Health services les mieux adaptés pour les soutenir et favoriser leur implication Services Steering Committee located at the Couchiching Family Health auprès de leurs enfants transgenres. Team, is a founding member of and organizes with Trans Liberation Now! (a community-empowerment group by and for Two Spirit and Natasha Dionne is a clinic social worker. She studied in Trans people in Simcoe County), and runs LGBTQ2SI+ youth groups. psychology, art-therapy and social work. Actually, she pursue a Ph.D, in social work, at University de Montreal’s Research Chair dedicated to Tatiana B. Ferguson is a Project Coordinator and Sexual transgender children and their families. Her studies are dedicated to the Health Educator. Since her arrival to Canada from the Bahamas in parents of transgender children to help develop the most appropriate 2014, she has been very active advocating for the inclusion of Trans services to support them and encourage their involvement with their people and people of color in community programs and services. Her children. work is informed by an anti-oppression framework and incorporates an intersectional approach which considers how various aspects of Benjamin Drainville Étudiant au baccalauréat en Sexologie à one’s identity can inhibit equitable access to programs and services. l’Université du Québec à Montréal (UQÀM). Militant trans et pansexuel, Currently, she is working on the TransFormed project; a community- allié des communautés de la diversité sexuelle et membre de Fierté based research and intervention project at METRAC: Action on Agricole. Violence to address Partner Violence from Two-Spirit, Nonbinary and Trans peoples perspectives. She is also a founding member of the Benjamin Drainville has a bachelor’s degree student in Black Queer Youth Collective (BQYC); a grassroots group dedicated to sexology from the University of Quebec at Montreal (UQAM). As a trans serving Black Queer and Trans youth in Toronto. and pansexual activist, he is an ally of sexually divers communities and member of Fierte Agricole.

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Tatiana B. Ferguson est coordonatrice de projet et éducatrice Ky Fleming is a young and energetic transgender man. Having en santé sexuelle. Depuis son arrivée au Canada en provenance des given several testimonies to high school students, school boards as Bahamas en 2014, elle milite activement en faveur de l’inclusion des well as medical professionals, he has several years of experience with personnes transgenres et de couleur dans les programmes et services public speaking to various crowds in different sectors. He has also, communautaires. Son travail s’inspire d’un cadre antioppression worked several times in the past in close collaboration with Gender et intègre une approche intersectionnelle qui examine comment Creative Kids, a community organisation that actively supports LGBT divers aspects de l’identité d’une personne peuvent nuire à un accès youth and their families. Having done conferences about Trans health équitable aux programmes et services. Elle travaille présentement and LGBT activism since 2015, at the age of 16, he excels in talking to sur le projet TransFormed : un projet de recherche et d’intervention large crowds about all and nothing. No subject is too shameful or not communautaire Action on Violence à METRAC qui aborde la question worth an honest answer. de la violence entre partenaires du point de vue des personnes deux esprits, non binaires et trans. Elle est également membre fondatrice Raymond Fung did his residency and endocrine training at U du Black Queer Youth Collective (BQYC), un groupe communautaire of T. He practices general endocrinology at Michael Garron Hospital, au service des jeunes Queers noirs et transgenres à Toronto. Le BQYC formerly Toronto East General. He has a special interest in providing utilise des approches dirigées par des pairs pour élaborer et faciliter trans care and has seen over 1000 trans patients. He is actively des programmes adaptés à la culture des jeunes LGBTQ+ noirs involved in educating residents about trans care and involved in âgés de moins de 29 ans. The BQYC utilizes peer-led approaches to research projects related to trans care. develop and facilitate culturally relevant programs to support Black LGBTQ+ youth under 29 yrs old. As a Black trans woman, her lived experience has fuelled her passion and drive to create alternative G models of support and inform best practices for system change so that underserved groups have access to a better quality of life. Gabriel J. Galantino est candidat au doctorat à l’Université du Québec à Montréal et sexologue clinicien au Centre de Santé Meraki. Natalie Finner is a paediatrician who received her Homme trans militant pour les droits de sa communauté, Gabriel undergraduate degree at McMaster University and her medical degree s’implique au niveau communautaire et en recherche depuis sa at the University of Limerick in Ireland. She completed her paediatric dernière année de baccalauréat en sexologie. Ses intérêts de recherche residency training through the Children’s Hospital of Eastern Ontario in portent sur les réalités des jeunes trans, plus spécifiquement l’accès Ottawa. She is currently an Adolescent Medicine subspecialty resident aux ressources, les vulnérabilités et la résilience, la sexualité et les at BC Children’s Hospital in Vancouver. On completion of her training, approches cliniques affirmative dans le genre. Natalie aims to continue incorporating advocacy for pediatric gender diverse youth within her career through her clinical practice and Gabriel J. Galantino is a doctoral candidate at the University scholarly work. of Quebec in Montreal and a clinical sexologist at Meraki Health Centre. As a trans activist, Gabriel has been engaged at the community Olivia Fischer BKIN, is a queer settler who lives, studies, level and in research since the last year of his bachelor’s degree in and works on the unceded territories of the Coast Salish people. sexology. His primary research focus is on the realities of trans youth, Presently working on her MA in Counselling Psychology at UBC, she more specifically on their access to resources, their vulnerabilities and is passionate about providing a non-judgemental atmosphere that resiliency, sexuality, and the affirmative clinical approaches to gender. fosters self-awareness for her clients. For her thesis, she has chosen to focus on the birth stories of transmasculine and non-binary people. Susan Gapka Actively engaged in this work, she is committed to elevating the voices is a founding member and chair of the Toronto Trans Coalition Project of marginalized people and resisting the negative heteronormative, which emerged from the work of the Trans Lobby Group. Susan helped transphobic beliefs and messages that are prevalent within our culture. lead the Ontario campaign to fund transition related surgeries, helped In addition, she researches sexuality in both the transgender and change the Statistics Act so trans people’s legal documents more cancer world. She works for the Ending Violence Association of British accurately reflect their lived identity, and drafted the legislation to Columbia, coordinating and facilitating workshops on preventing amend the Ontario Human Rights Code and Canadian Human Rights and responding to intimate partner violence in queer and trans Act to include ‘gender identity’ and ‘gender expression.’ communities.

Krista Genoway Dr. Genoway is a board-certified plastic and Ashley Flanagan is a PhD candidate in the Aging, Health, and reconstructive surgeon based in Vancouver, BC. She completed her Wellbeing Interdisciplinary Program of the Faculty of Applied Health medical school and residency training in plastic and reconstructive Sciences at the University of Waterloo. Ash’s dissertation engages surgery at the University of British Columbia. She then completed a innovative improvisational inquiry that melds components of queer fellowship in reconstructive microsurgery with a sub-specialty focus on theory, community belonging, aging, and case study research in order providing gender-affirming surgical care in San Francisco, California. to challenge many of the taken-for-granted understandings of sex, Dr. Genoway began offering upper surgery in 2016 and lower surgery gender, and health regarded as the Truths of aging. In addition to these in 2019. She is a clinical instructor in the Department of Surgery at academic projects, Ash coordinated the inaugural Transgender Health UBC and is active medical staff within Vancouver Coastal Health. and Wellness Conference for practitioners in Waterloo Region.

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Krista Genoway Dre Krista Genoway est une chirurgienne University/Montréal Children’s Hospital. After an undergraduate degree plasticienne et reconstructive certifiée , basée à Vancouver, en in Biology and Hispanic/ Italian Linguistic Studies at Johns Hopkins Colombie- Britannique. Elle a terminé ses études de médecine et sa University in Baltimore, Maryland, he obtained his medical degree résidence en chirurgie plastique et reconstructive à l’Université de at the University of Illinois at Chicago Medical School, followed by la Colombie-Britannique. Elle a ensuite complété un fellowship en residency in Pediatrics at Georgetown University in Washington, DC. microchirurgie reconstructive avec une sous-spécialisation dans la prestation de soins d’affirmation de genre chirurgicale à San Francisco, Lorraine Grieves is a registered clinical counsellor and health Californie. Dre Genoway a commencé à offrir la chirurgie thoracique en care administrator who has worked in a range of roles, from therapist 2016 et la chirurgie génitale en 2019. Elle est instructrice clinique au to program director, supporting the wellness of youth and families département de chirurgie de l’Université de la Colombie-Britannique et in diverse settings. She currently lives and works on the ancestral, fait partie du service médical actif de Vancouver Coastal Health. traditional and unceded territory of the xʷməθkwəy̓ əm (Musqueam), Skwxwú7mesh (Squamish), and Tsleil-waututh nations in a program Felix Gilliland is an activist and community organizer in director role with Trans Care BC at PHSA, enhancing and coordinating Vancouver, BC. They are working to improve access for trans people to services for trans and gender diversepeople in British Columbia, Canada. traditionally women-only sexual assault centers by asking feminists to reimagine the borders of women’s space, balancing an understanding Lorraine Grieves est conseillère clinique agréée et membre of systemic violence with an interrogation of identity as a central actif de la British Columbia Association of Clinical Counsellors. organizing factor. In this work, they are challenging feminist and Elle est titulaire d’une maîtrise en psychologie du counseling et, queer theories to expand on each other. Felix is also involved in legal depuis le début des années 1990, elle travaille comme intervenante challenges to state-certified gender, as an executive member of the professionnelle dans une variété de rôles et de programmes. Gender-Free ID Coalition. They are passionate about healthy queer communities that are political, consensual, and loud. anya gwynne is a queer, genderflux writer, performance artist and troublemaker in Peterborough, ON. They have an honours Eli Godwin, MEd (he/him) is a trans man and the study degree in English Literature and Cultural studies and a background in coordinator and a data analyst for the Trans Teen and Family expressive arts. As Education Coordinator at PARN- Your Community Narratives Project (PI: Dr. Sabra Katz-Wise), a longitudinal study with AIDS Resource Network, anya presents dynamic workshops, to a transgender youth and their family members, including siblings. After wide range of stakeholders, on several topics including best practices earning his MEd from Harvard University, Eli spent fifteen years as for working with trans and non-binary populations, safer sex, sexual a secondary science educator, during which time he was inspired to orientation, gender identity and the development of accountable turn his attention to public health in order to have a more systemic spaces. They facilitate the Rainbow Youth Program, working to impact on the well-being of adolescents and sexual and gender increase the support, visibility and opportunities for 2-SLGBTQIA youth minorities. He is a member of the Sexual Orientation and Gender in our community. Identity and Expression (SOGIE) working group in the Division of Adolescent Medicine at Boston Children’s Hospital and an MPH candidate in social determinants of health. Eli has served as a panelist H and presenter at transgender wellness conferences around the northeastern US and engages in policy and advocacy work on behalf Aleah Hazan Dr. Aleah Hazan is in her 5th year of Obstetrics of transgender youth and athletes. When not immersed in public & Gynecology residency at the University of British Columbia. She health, Eli can be found playing in the sky or on frozen water. Ask him completed her undergraduate degree at Queen’s University and her anything his own experiences as a trans person or the fabulous sports Master’s of Science and medical school at the University of Toronto. of skydiving and curling! Her clinical interests include the care of marginalized women, both locally and abroad. Lindsay Goodridge (she/her) completed the H BSc in Biology (U Guelph) and the BSNutrition at Acadia U. At the time of the CPATH Silvana Hernando is the Trans Health Clinical Educator at conference, she will be a student in the MPH (Nutrition) program at Rainbow Health Ontario (RHO). She facilitates educational seminars U of Toronto. While at Acadia, she served as Cath Morley’s research for health care providers regarding HRT, transition-related surgeries, assistant studying the eating experiences and nutrition concerns of and mental health. Before joining RHO, Silvana worked for 18 years gender variant individuals to further the development of best practice with T/GNC/NB clients providing psychotherapy from a trans- positive, guidelines. In this role, she was a panelist at three trans nutrition and trauma- informed framework. She specialized in working with trans health events (2 at Mount Saint Vincent U, and at Memorial racialized, immigrant, and refugee populations. In 2002, Silvana co- University of Newfoundland). She is committed to spreading the founded the first clinical supervision group for mental health providers message of trans-inclusivity throughout her career. in Canada working with trans clients from a trans-positive perspective.

Dr. Shuvo Ghosh is one of the two Co-Directors of the Meraki Lisa Howard PhD RN is an Assistant Professor in the Faculty of Health Centre and the head of the Montréal Pediatric Gender Variance Health Sciences at the University of Lethbridge, who does research in Program based at Meraki and at McGill University. He completed the areas of communication, chronic disease management in adults, the majority of his education in the USA before arriving in Canada to undergraduate nursing education, and sexual expression in residents do his fellowship in Developmental- Behavioural Pediatrics at McGill of long-term care organizations.

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Suza Hranilovic is a Primary Health Care Nurse Practitioner at Natasha Johnson, Dr. Natasha Johnson is a pediatrician and St. Michael’s Hospital Academic Family Health Team. She considers Adolescent Medicine Specialist. After graduating from McGill Universi- herself an “old nurse” of 30 years and a newer Nurse Practitioner ty, she completed a fellowship in Adolescent Medicine at the Hospital of 7 years. She is a consultant trainer with Rainbow Health Ontario, for Sick Children in Toronto. For the past 12 years she has been a expanding capacity provincially by teaching about trans and gender member of the Department of Pediatrics at McMaster University where diverse medical and surgical primary health care. Suza has a com- she is now an Associate Professor and Division Head of Adolescent mitment to continuing involvement in professional development and Medicine as well as the medical co-director of their Eating Disorder community-based volunteer activities which have included Board of Program. Dr. Johnson has developed a clinical, educational, and Directors positions with the Canadian Association of Nurses in AIDS research focus in the area of adolescent sexual health – in particular Care, the Ontario HIV Treatment Network and Fife House Founda- in marginalized youth and vulnerable populations. Recognizing the tion. Sue is proud to have been one of the founding members of the need to have increased access to gender affirming care, she estab- Committee for Accessible AIDS Treatment and to have participated in lished a clinical service for trans and gender diverse youth at McMaster volunteer nursing in Zimbabwe. She has done over 60 presentations Children’s Hospital in 2016. to colleagues, patients and community and has received ten awards of excellence in academia and clinical care. Sue’s high level of expertise Fae Johnstone, is an educator, consultant and writer working and commitment to working with diverse, marginalized, stigmatized, on unceded, unsurrendered Algonquin territory (Ottawa, ON). As an at-risk and vulnerable populations has served her both locally and educator, they have provided training to hundreds of service providers internationally, and she hopes to continue nurturing the resilience of across Canad on LGBTQ2+ and trans inclusion. As a consultant, she the clients she walks with, learns from and serves. has worked with a diversity of organizations on local, provincial and national projects focused on public education, community engagement and youth issues. Over the past year, Fae has had by- lines appear I in the Ottawa Citizen, the Toronto Star and the Huffington Post. All of Fae’s work is driven by a desire to do better by, for and with marginal- Dayla Israel is a feminist, a rape crisis center advocate, and a ized communities. She can be found on Twitter at @Fae Johnstone and mother. After finishing her BA in Women’s Studies from the Universi- contacted through her website, faejohnstone.com. ty of British Columbia with a focus on Critical Studies in Sexuality in 2005, she started with WAVAW, and after 16 years of frontline work she Caroline Jourdain is now the Executive Director. Having the opportunity to work with indi- Formatrice auprès d’enseignants, d’intervenants et de jeunes en milieu vidual women has also allowed her to bring women’s voices forward in scolaire (écoles primaires, secondaires, CFP, CEGEPs et universités) circles of influence in order to highlight systemic barriers that survivors pour l’organisme Enfants Transgenres Canada depuis 2017, Caroline of sexual assault experience in both the Medical and Criminal Justice donne aussi parallèlement des conférences et des témoignages systems. She is very passionate about supporting the survivors WAVAW en entreprise et auprès de professionnels de la santé. Membre de serves to access Justice in meaningful ways after a sexual assault. plusieurs groupes (locaux, nationaux et internationaux) de parents d’enfants transgenres sur Facebook, Caroline est d’abord et avant tout, la fière mère de Ky, jeune homme de 20 ans. J Caroline Jourdain is an instructor for teachers, practitioners Dr. Ted Jablonski is an award winning family physician based and youth in schools (elementary, secondary, CFP, CEGEPs and in Calgary, Alberta, Canada. In addition to family medicine, Ted is the universities) for Transgender Children Canada since 2017. Caroline medical director of Jablonski Health and Skipping Stone Foundation also gives conferences and presentations to companies and with health doing consultant work in sexual and transgender medicine for South- professionals. She is a member of several groups (local, national and ern Alberta for over a decade. Ted is a sought after speaker, trainer, international) of parents of transgender children on Facebook. Caroline media spokesperson and educator with many conference, radio, tele- is first and foremost, Mother to her 20-year son Ky. vision and video credits. “dr j” is a multi-instrumentalist, singer-song- writer with 10 indie CD releases, is a published author and passionate emerging playwright. He strives to be a strong advocate and ally to the K LGBTQ+ community. Alex Karn works full-time with Gender Journeys, a program Corey Johnson, Dr. Corey W. Johnson is a Professor in the offered by the Canadian Mental Health Association Haliburton, Department of Recreation and Leisure Studies at the University of Kawartha, Pine Ridge (CMHA HKPR). In his role as an Education and Waterloo. He teaches courses on inclusive recreation, social justice, Support Worker, he provides one-on-one and group support for trans gender and sexuality, qualitative research methods, and the philosophy and questioning folks as well as their loved ones, in addition to public of science. His theorizing and qualitative inquiry focuses its attention education and advocacy for the trans community in Peterborough on the power relations between dominant (white, male, heterosexual, and throughout the four-county footprint CMHA HKPR serves.Before etc.) and non-dominant populations in the cultural contexts of leisure. working with Gender Journeys, Alex wrote for various community news- papers and editorial publications, often highlighting local social issues and raising awareness for LGBTQ organizations and initiatives. Alex is a proud father, feminist, musical theatre nut, and queer transgender

76 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA man living in Peterborough, Ontario with his 10-year-old daughter and Valeria Kirichenko est étudiante à la maîtrise en travail social chosen family. à l’École de travail social de l’Université de Montréal. Faisant partie de la Chaire de recherche du Canada sur les enfants transgenres et leurs Alex Kavanagh Dr. Kavanagh is a reconstructive urologist familles, ses travaux se concentrent sur les expériences des enfants certified by the Royal College of Physicians and Surgeons of Canada. trans et de leurs parents dans un contexte clinique. Valeria travaille He completed medical school at the University of Calgary and a Master également à l’organisme Enfants Transgenres Canada, où elle coor- of Public Health at Harvard University. His urologic residency was donne le projet “Bonjour SAM: sensibiliser les jeunes par le jeu”, un completed at UBC, and he has since completed a fellowship in female projet visant à fournir des outils de sensibilisation aux écoles primaires pelvic medicine and reconstructive surgery in Houston, as well as a québécoises afin de lutter contre la transphobie en milieu scolaire. fellowship in male urethral and pelvic reconstruction with Dr. Sanjay Kulkarni. Dr. Kavanagh has also completed visiting fellowships at Valeria Kirichenko is a master’s student at the University of several centres of excellence in gender- affirming surgery, including Montreal’s School of Social Work. Being part of the Canada Research Crane and Brownstein Surgical (Drs. Curtis Crane and Richard Chair on Transgender Children and their Families, her work focuses Santucci), Dr Mang Chen (Bunke Clinic, San Francisco), the New York on the experiences of trans children and their parents in a clinical Langone School of Medicine (Dr. Lee Zhao) and Mount Sinai Hospital context. Valeria also works at Gender Creative Kids Canada, where (Dr. Ting). she coordinates the “Hi SAM: Sensitizing youth through play” project, which aims to provide sensitization tools to elementary schools in Alex Kavanagh Dr Alex Kavanagh est un urologue spécialist en Quebec in order to fight against transphobia in school settings. chirurgie reconstructative certifié par le Collège royal des médecins et chirurgiens du Canada. Il a fait ses études de médecine à l’Université Chiaki Konishi Ph.D., is an Assistant Professor in the de Calgary et obtenu une maîtrise en santé publique à l’Université Department of Educational and Counselling Psychology at McGill Harvard. Sa résidence en urologie a été complétée à l’Université du University, specializing in the area of social-emotional learning (SEL) Colombie-Britannique, et il a par la suite complété une bourse de and development. Most of Chiaki’s work has been conducted through recherche en médecine pelvienne féminine et chirurgie reconstructive collaborative partnerships with local schools and community agencies, à Houston, ainsi qu’une bourse de recherche en reconstruction aiming at optimizing social-emotional development of children and urétrale et pelvienne chez l’homme avec Dr Sanjay Kulkarni. Dr youth as well as learning environments/school climate. Her current Kavanagh a également été boursier invité dans plusieurs centres focus has been the application of social and ecological perspectives prestigieux de chirurgie d’affirmation du genre, notamment les centres to understand developmental processes, with emphasis on multilevel de Crane et Brownstein Surgical (Dr Curtis Crane et Dr Richard and growth modeling techniques, as well as marginalized populations Santucci), Dr Mang Chen (Bunke Clinic, San Francisco), New York of youth, including sexual and racial minorities, especially in relation to Langone School of Medicine (Dr Lee Zhao) et Mount Sinai Hospital (Dr their stigmatized experiences of being bullied. She has been an active Ting). member of PREVNet, Canada’s national organization for Promoting Relationships and Eliminating Violence Network, and the international Peter Kellett Ph.D. RN is an Assistant Professor in the Faculty Bullying Research Network, linking 180 experts globally. She has of Health Sciences at the University of Lethbridge with a research taught a unique graduate-level practicum course in SEL, the first of its program focused on social inequalities and population health, with kind in Canada initiated by Drs. Kimberly Schonert-Reichl and Shelley particular focus in the areas of LGBTQ2S+ health and masculinities Hymel, providing opportunities for teacher candidates to develop a and health. Peter has worked for the last 24 years as a registered deep understanding of embedding SEL in educational settings. nurse, nurse educator, and manager, in both provincial and federal (FNIHB) health systems in three Canadian provinces, and one U.S. Yonah Krakowsky is a proud graduate of the University of State, in the areas of medical/surgical care, emergency care, primary Toronto urology program and returned as faculty last year at Women’s health care, community health, and First Nations health. He also runs College Hospital and Mount Sinai Hospital. He is the medical lead of the website Gender and Population Studies (GAPS) in Health (www. the Transition Related Surgery (TRS) program at Women’s College gapsinhealth.com) Hospital and the Assistant Program Director of the Urology residency program Karine Khatchadourian Dr. Karine Khatchadourian completed medical school and a pediatrics residency at the University Yonah Krakowsky est fière d’être diplômée du programme of Montreal. She then completed her fellowship in pediatric endocrinol- d’urologie de l’Université de Toronto. L’an dernier, il est retourné au ogy at BC Children’s Hospital at the University of British Columbia. She Women’s College Hospital comme directeur médical du programme also obtained a Master’s in health sciences at the University of British de chirurgie de transition et à l’hôpital Mount Sinai dans le poste de Columbia. She joined the Division of Endocrinology at the Children’s directeur adjoint du programme de résidence en urologie. Hospital of Eastern Ontario (CHEO) in 2014. Dr Khatchadourian is a clinical investigator in the evidence to practice research program of the Johnathan Kuipers RSW, Supervisor, Group Programs, CHEO Research Institute. Her research and clinical interests are in the Skipping Stone, Calgary, Alberta area of pediatric bone health, endocrine management of transgender youth and general endocrinology.

=

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and resilience. She is also a member of the Trans Women HIV Research L Initiative (TWIRI) and the CTN Trans People and HIV Working Group.

Henri Labelle est diplômé en sciences de l’Université de Louise Lacroix Notre Mission, les objets pour lesquels Montréal ainsi qu’en service social de l’Université du Québec à l’Organisme TRANS-M/CDQ est constitué sont les suivants : Accueillir, Montréal. Il a aussi été formé en psychothérapie spécialisée dans les soutenir et référer les personnes englobant la DIVERSITÉ DE GENRE troubles de la personnalité. Monsieur Labelle a donné à plusieurs ou en questionnement ainsi que leurs proches; Rencontrer des jeunes, reprises des conférences et de la formation sur les traitements actuels adultes et la population dans le but de démystifier la DIVERSITÉ en psychothérapie des troubles de la personnalité aux étudiants en DE GENRE; Présenter des conférences, participer à des ateliers et santé mentale de l’Université du Québec en Outaouais. Il a d’ailleurs diffuser des documents écrits ou audiovisuels faisant la promotion de participé à la supervision clinique de jeunes travailleurs sociaux. l’égalité des citoyens; Informer et sensibiliser la population aux effets En début de pratique, il a œuvré auprès des lignes d’intervention négatifs de la transphobie. Informer, sensibiliser, éduquer les différents téléphonique de crise suicidaire puis comme intervenant dans un professionnels à intervenir avec la clientèle de la DIVERSITÉ DE centre de crise. Il a ensuite pratiqué 6 ans dans le réseau de la santé GENRE. www.transmcdq.com à l’urgence psychiatrique de l’Hôpital de Saint-Jérôme ainsi qu’en CLSC. En parallèle, et ce depuis 10 ans, Henri Labelle offre de la Louise Lacroix Our Mission, the goals of the Organization psychothérapie dans la clinique qu’il a fondée dans les Laurentides. TRANS-M/CDQ are as follows: Welcome, support and refer GENDER Reconnu pour ses aptitudes cliniques, Monsieur Labelle occupe le DIVERS or gender questioning people and their relatives; Meet young poste de travailleur social au Centre Métropolitain de Chirurgie depuis people, adults and the public in to demystify the GENDER DIVERSITY; le printemps 2018. Present conferences, participate in workshops and disseminate written or audiovisual documents promoting the equality of all citizens; Henri Labelle is a graduate in science from the University of Inform and raise awareness about the negative effects of transphobia. Montreal and in social work from the University of Quebec in Montreal. Inform, raise awareness, and educate the various professionals to work He has also trained in psychotherapy specializing in personality with the clientele of the DIVERSITE DE GENRE. disorders. Mr. Labelle has given several conferences and training www.transmcdq.com sessions on current treatments in psychotherapy for personality disorders to students in mental health at the Universite du Québec en June Lam is a psychiatry fellow and a Master’s student in Clinical Outaouais. He has also participated in the clinical supervision of junior Epidemiology & Health Care Research at the University of Toronto. social workers. At the beginning of his practice, he worked with the He has a clinical and research interest in working with underserved suicide hotlines and then as an intervener in at a crisis center. He then and marginalized populations, including with transgender and gender practiced for 6 years in the health services at the emergency psychiatric diverse, homeless, and new immigrant populations. He is part of unit of Saint-Jerome Hospital as well as in the CLSC. For the past 10 the Clinician Scientist Program (CSP), working on a CIHR- funded years, Henri Labelle has been offering psychotherapy in the clinic qualitative study understanding the suicidal behaviour of Chinese and he founded in the Laurentians. Recognized for his clinical skills, Mr. Chinese-Canadian women. His Master’s thesis is looking at access Labelle has been a social worker at the Metropolitan Surgical Center to mental health care for transgender and gender diverse individuals since the spring of 2018. after discharge from psychiatric hospitalization. His clinical fellowship is focused on developing his skills in providing affirming mental health Sophie Labelle care to trans youth. is an internationally renowned visual artist and author from the South shore of Montréal. She is the transgender cartoonist behind Assigned Carrie Lawford (she/her pronouns) is a Social Worker in the Male, a webcomic about a group of queer and trans teenagers that has Adult Gender Clinic at the Centre for Addiction and Mental Health been running since 2014 and already touched millions of readers. (CAMH) in Toronto. She has a Bachelor of Social Work from the University of Manitoba and a Master of Social Work from the University Sophie Labelle est un artiste visuel et auteur reconnu of Toronto (Adjunct Lecturer Status). She currently provides assessment internationalement de la Rive-Sud de Montréal. Elle est la caricaturiste and affirming psychotherapeutic treatment for clients working towards transgenre derrière Assigned Male, une bande dessinée en ligne au readiness for transition-related surgeries. She is an advocate of sujet d’un groupe d’adolescents homosexuels et transsexuels qui court increased competency in primary care as a means of increasing health depuis 2014 et qui rejoint déjà des millions de lecteurs. equity within trans and gender expansive communities.

Ashley Lacombe-Duncan is an Assistant Professor at the Margaret Lawson Dr. Margaret Lawson is a pediatric University of Michigan School of Social Work. She conducts research on endocrinologist at CHEO, Senior Investigator at the CHEO Research healthcare access and health equity, with a particular focus on healthcare Institute, and Professor of Pediatrics at the University of Ottawa. access for people who experience multiple forms of intersecting Margaret has provided hormone therapy and gender affirming care oppressions. Specifically, she has spent the last many years working and support to trans youth since 2006, forming CHEO’s Diversity collaboratively with community-based researchers and the Canadian HIV Clinic in 2011 with Dr. Steve Feder. Together with their team, they Women’s Sexual and Reproductive Health Cohort Study to bring to light have witnessed first-hand the growth in this population, and the issues affecting trans women living with HIV in Canada, including access strength the youth and their families provide to each other. She is a to HIV care, access to gender- affirming medical care, mental health, co-Principal Investigator for the ‘Trans Youth CAN!’ cohort study, and a

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Co- Investigator on the ‘Stories of Gender-Affirming Care’ qualitative Reese Malone Dr. Reece Malone is the CEO and Lead Trainer study. She is very excited to be working on studies to help answer and Supervisor of Diversity Essentials. He is a certified sexologist and questions that are important to trans youth, their family members, holds a Masters of Public Health and Doctorate of Human Sexuality. and health professionals. She is very excited to be working with the Dr. Malone is a certified sexuality educator and supervisor through team to move these studies forward and is really grateful to all the the American Association of Sexuality Educators, Counselors and youth and families who have contributed to the development of Trans Therapists, and a Florida State certified sex therapist. As a sexual Youth CAN! and Stories of Gender-Affirming Care projects. health educator and advocate, he provides sexuality consultation and education to service providers and the public.From 2008 to 2017 he Bridget Liang is a mixed race, queer, transfeminine, served as the Education Program Coordinator at the Rainbow Resource neurodiverse, disabled, fat fangirl. They came into their queerness Centre (Winnipeg, Manitoba) specializing in public education and in Hamilton Ontario and co-founded RADAR Youth Group at the consultation on sexual orientation and gender identity in the health, LGBTQ Wellness Centre (the Well), the first queer group in a high education, social services, and corporate sectors. He also served school in Hamilton, and were instrumental in the passing of an equity as the Transgender Health Program coordinator at Mount Carmel policy in the HWDSB. They have worked for a number of queer/trans Clinic (Winnipeg, Canada) to establish programs and protocols for organizations and groups over the years both in Hamilton and Toronto. clinicians and administrators when working with transgender and They have been involved with community research, workshop and gender independent populations. He’s been a consultant to several group facilitation, and doing performance art and currently facilitate local, national, and international bodies including the World Health the Autistiqueers group in Toronto while working on a PhD at York Organization/Pan American Association, The Public Health Agency of University. Student activist. Canada, The Canadian AIDS Information and Treatment Exchange, and the Canadian Human Rights Commission.Dr. Malone is the author of ShoutOut Against Homophobia, Biphobia, Transphobia and M Heterosexism. In its second version, ShoutOut has been distributed to more than 90,000 youth and adolescents across Canada. Emilie Maine holds a Bachelor of Arts in Social and Cultural Anthropology and is currently in her Master of Arts in Educational Alexa Marr Dr. Alexa Marr, Children’s Hospital of Eastern Research specializing in Curriculum and Learning. Emilie’s research Ontario, University of Ottawa, Ottawa, Ontario focuses on queer and trans access to sexuality education in rural Albertan communities. She was named Top 30 Under 30 by the Michael Marshall Dr. Michael Marshall, MBBS, MRCPsych, Alberta Council for Global Cooperation in 2018. Most recently, Emilie PgDip (Mental Health Law), CCT, is a psychiatrist with a special co-developed a social justice leadership program for grade four to interest in the health and wellness of the gender diverse population. six students in Fort McMurray, Alberta. Emilie runs her own website He trained in the UK and was inaugural Program Director for the where she writes about issues facing the queer and trans community. Gender Program at the University of Alberta Hospital in Edmonton, Alberta, Canada. Michael Marshall started this new, innovative James Makokis, is a nehiyô (Plains Cree), Two Spirit program with a view to providing comprehensive, multidisciplinary, physician from Onihcikiskwapiwinihk (Saddle Lake Cree Nation) wraparound care and service navigation to the gender diverse who practices Family Medicine in Kinokamasihk (Kehewin Cree population in Edmonton and the north of Alberta. He is a clinician at Nation) and South Edmonton. His passion drives him to elevate the heart but has engaged with various projects. He is an advocate for nehiyô health system, which includes the use of nehiyâw maskihkiya provision of good care and speaks widely on various topics. (Cree medicines). In addition to his work with First Nations Peoples, Dr. Makokis has a strong interest in providing high quality care to Zack Marshall Dr., Assistant Professor, School of Social Work, the Trans q-mmunity. Outside his clinical practice, Dr. Makokis has McGill University served as Chairperson of the Indigenous Wisdom Council of Alberta Health Services, and is a Board Member of the Waakebiness-Bryce Marie-Jeanne Martin est médecin généraliste. Elle travaille Institute of Indigenous Health at the University of Toronto. He holds dans une maison médicale à Lille (France) “La Maison Dispersée a Masters of Health Science from the University of Toronto and is a de Santé”et dans le service d’orthogénie de l’hôpital d’Armentieres. recipient of the National Aboriginal Achievement Award. Dr. Makokis is Féministe engagée dans la santé des femmes, la santé des minorités an Associate Clinical Professor in the Department of Family Medicine, sexuelles ainsi que celles des plus démunies, elle se définit comme University of Alberta and an Adjunct Professor at the Dalla Lana School une militante de médecine générale (migrants, addictions, ivg, transi- of Public Health, University of Toronto. He is an endurance athlete and tions, aide à la parentalité). competes in races above 100km in length, and has completed various marathons throughout the world. He believes in the importance of Marie-Jeanne Martin is a general practitioner. She works in nehiyô cihcikewina (ceremonies), nehiyawewin (the Cree language), a medical residence in Lille (France) “La Maison Dispersée de Sante” and nehiyô mamitoneyitamowin (Cree thought) in living a healthy life. and in the orthogeny department of the Armentières hospital. She He married his husband Anthony Johnson during the 2017 Vancouver defines herself as a general medical activist—a feminist committed to International Marathon, where they said “I do, at KM 32.” Together the health of women, the health of sexual minorities as well as those they competed as “Team Ahkameyimok” in Season 7 of The Amazing of the most disadvantaged, (migrants, addictions, ivg, transitions, Race Canada and won while bringing attention to several important parental assistance). messages including MMIW, two spirit and transgender issues, “Water Is Life,” Treaty and Indigenous languages. 79 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Cathy Maser has been a paediatric nurse for over 30 years, Denise Medico is a professor in the sexology department of working at The Hospital for Sick Children for the past 29 years in the the University of Quebec in Montreal. Her research activities aim to Cardiac Critical Care unit, the Division of Neonatology, the Acute Care develop affirmative and reflective clinical practices and to promote the Transport Team and the Emergency Department. Since obtaining her well-being of young trans people and their families. She works in a Master of Nursing degree at the University of Toronto in 2007, she phenomenological, systemic, critical and situated approach. She also has been working as a Nurse Practitioner in the Division of Adolescent practices as a psychologist at the Centre de Sante Meraki in Montreal Medicine. Her clinical focus is with youth with chronic illness, sub- and has over 15 years of experience in trans health in Canada and stance misuse, sexual health, gender identity and minor mood Switzerland where she co-founded the Agnodice Foundation, an NGO disorders. Cathy is a founding member of the Transgender Youth Clin- that defends the rights of trans people and disseminates inclusive ic since it’s opening in October 2013. She is Team Lead for the clinic practices. She is a member of WPATH and CPATH as well as the and is actively involved in partnerships within the transgender care Scientific Council of the WAS (World Association for Sexual Health). community and often provides education to schools, parents, health care providers and community agencies on adolescent brain develop- Sfé R. Monster (they/them) is a trans, queer comic creator ment, mental health, substance use and non-binary gender identities. who is deeply invested in the telling of queer and transgender stories. For the past 12 years she has been on faculty at the Lawrence S They are the editor of the Lambda award-winning Beyond: The Queer Bloomberg Faculty of Nursing, University of Toronto as a Lecturer in Sci-Fi & Fantasy Comic Anthology, co-founder of Beyond Press, and the Undergraduate and Nurse Practitioner programs. creator of the ongoing comic Eth’s Skin. Sfé lives and works in Halifax, NS, and has had their work published by Harper Collins, Oni Comics, Dr. Fiona Mattatall (she/her) is a native Calgarian who had and Boom. a background in biochemistry prior to completing medical school at Queen’s University. From there she went onto residency in Obstetrics L.B. Moore, MEd (they/them) is a white, non-binary, trans Jew and Gynaecology at Dalhousie University and returned to Calgary to with disabilities who holds an ever-growing anti-oppression frame, work at the Rockyview Hospital. She had been working with trans two MEds from Boston University, and as many puppies at once health for a decade and focuses on gynaecologic aspects of trans care as possible. They work as a Behavioral Health Clinician at Boston and education of other medical professionals in trans health. GLASS (a program of Justice Resource Institute), a community- based organization providing a continuum of services for LGBTQ+ youth of Michelle McCarron Dr. McCarron is a Research Scientist color, where LB specializes in providing behavioral health services with the Saskatchewan Health Authority. She is embedded within the to QTPOC living with HIV. They are also an interviewer and data University of Saskatchewan’s Department of Family Medicine in Regina, analyst at Boston Children’s Hospital as part of the Trans Teen and SK as a Clinical Associate Professor, providing research mentorship Family Narratives Project (PI: Dr. Sabra Katz-Wise), a longitudinal and collaboration with physicians and residents. Dr. McCarron holds study investigating the impact of social support on health outcomes a PhD in Experimental and Applied Psychology from the University of transgender youth and their family members. LB has presented at of Regina and is an ally of the LGBTQ2+ community. In addition to conferences such as APA as well as Boston-area gatherings such as her collaborations with Dr. Clark and the Saskatchewan Trans Health First Event, focusing on topics around transness. Coalition, her current research interests include Post- Traumatic Stress Injuries in Public Safety Personnel and research ethics. Catherine Morley Sfé’s mom, works as a nutrition researcher and professor at Acadia University (Wolfville NS), and writer, and Krishia McLaren Dr. McLaren is a first year family medicine worked as a clinical dietitian/manager and independent researcher resident in Regina, Saskatchewan. She has a passion for inclusive before joining Acadia. Cath’s research interest is in developing/ mobi- primary health care. She hopes to be able to tailor her future practice lizing gender variant-appropriate clinical nutrition practice guidelines to focus on trans and gender diverse primary health care, women’s using client-centred, collaborative, participatory research approaches health, and mental health along with all other aspects of general to enhance access to and the quality of nutrition services for the family medicine. She is a passionate ally of the LGBTQ2+ community gender variant community. and hopes to be able to educate others regarding providing competent and compassionate care to those in the community. Adam Mullen Medical Student at University of Alberta, University of Saskatchewan Department of Family Medicine. Edmonton, Alberta

Denise Medico est professeure au département de sexologie de l’Université du Québec à Montréal. Ses activités de recherche visent N le développement de pratiques cliniques affirmatives et réflexives ainsi que le bien-être des jeunes trans et de leur famille. Elle travaille dans Karine Nadeau-Paquette J’ai terminé mon baccalauréat une approche phénoménologique, systémique, critique et située. Elle en psychologie en 2017 durant lequel j’ai fait de la sensibilisation pratique également comme psychologue au Centre de Santé Meraki sur la diversité de genre sur le campus de l’Université de Montréal à Montréal et a plus de 15 années d’expérience en santé trans au en partenariat avec le Groupe d’Action Trans. Je m’intéresse donc, Canada et en Suisse où elle a co- fondé la Fondation Agnodice, une depuis plusieurs années, aux questions d’identité de genre. Je fais ONG qui défend les droits des personnes trans et diffuse des pratiques présentement mon doctorat en psychologie clinique à l’UQAM sous la inclusives. Elle est membre de WPATH et CPATH ainsi que du conseil direction de Louise Cossette et Denise Medico. Je m’intéresse, dans scientifique de la WAS (association mondiale de santé sexuelle). le cadre de mon projet de recherche doctorale, à l’expérience des

80 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA parents ayant un enfant créatif dans le genre. Je désire développer une expertise clinique afin de travailler, comme future psychologue, O avec les jeunes trans et non-binaires et leur famille. Je considère important de soutenir la communauté et de favoriser la normalisation James Owen Dr James Owen is a family physician at Unity de la diversité sexuelle et de genre, ainsi qu’une plus grande dis- Health Toronto and an Assistant Professor in the Department of Fam- ponibilité et accessibilité des services transaffirmatifs. En dehors du ily and Community Medicine at the University of Toronto. His clinical cadre scolaire, je travaille comme intervenante en santé mentale à la practice focuses on LGBTQ2S health, HIV primary care and pre- Maison Jacques-Ferron, un organisme communautaire qui promeut vention, and the care of vulnerable populations. He is the LGBTQ2S la réinsertion sociale d’adultes vivant avec des difficultés liées à la Health Theme Lead for the MD Program at the University of Toronto, santé mentale. and the course director for “Complexity and Chronicity” in the second year of the MD Program’s Foundations Curriculum. He originally hails Karine Nadeau-Paquette completed a bachelor’s degree from Wawa, Ontario in psychology in 2017. During this time she raised awareness about gender diversity on the University de Montreal campus in partnership with the Trans Action Group, a topic which has interested her for sev- P eral years. She is currently doing a doctorate in clinical psychology at UQAM under the supervision of Louise Cossette and Denise Medico. Mark Palmert Dr. Mark Palmert is a Professor of Pediatrics and She is studying the experience of parents with a gender creative child Physiology at the University of Toronto. Mark completed his pediatrics as part of her doctoral research project. She plans on developing and pediatric endocrinology training at Children’s Hospital, Boston clinical expertise with trans and non-binary youth and their families to and held faculty appointments in Boston and at Rainbow Babies and work as a psychologist. She finds it imperative to support the commu- Children’s Hospital in Cleveland before moving to Toronto in 2007 to nity and to promote the normalisation of sexual and gender diversity, become Head of the Division of Endocrinology at SickKids. In 2017, as well as to promote greater availability and accessibility of trans-af- Mark began a new role as Associate Chair of Pediatrics (Ambulatory firmative services. Outside of school,she is a mental health worker at Care) at SickKids. Mark has a long-standing clinical and research Maison Jacques-Ferron, a community organization that promotes the interest in the regulation and disorders of pubertal timing. These social reintegration of adults living with mental health difficulties. interests and male-female differences in the timing of puberty led to the expansion of his laboratory-based program to include investigation Dr. Pam Narang is a Registered Psychologist with the Gender of the bases of sex differences in the brain, including examination of Clinic, Teaching & Consultation Clinic at B.C. Children’s Hospital the effects of sex steroids and sex chromosomes on brain structure (BCCH), and Clinical Instructor with University of British Columbia and function. In the clinical realm, Mark has focused on the care Department of Psychiatry. She provides education and training of children with general endocrine disorders but with a particular to residents in the areas of diversity and assessment for children interest in reproductive endocrinology, including disorders of pubertal and adolescents with complex mental health, developmental, and development and the care of transgender youth. In 2013, he co- functional concerns. She focuses on mental health and readiness founded the multi- disciplinary Transgender Youth Clinic at SickKids assessments, sharing knowledge about gender-affirming care, and along with colleagues in Adolescent Medicine. supporting the continued development of the Gender Clinic at BCCH. Dr. Narang also has a private practice in Vancouver where she serves Anne-Marie Parent is a Master’s student in Human children, adolescents, and their families. Development at McGill University, under the supervision of Dr. Chiaki Konishi. She is committed to social justice in her research and she Behdad Navabi is a second-year pediatric endocrinology fel- is interested in various topics related to both educational and non- low at the Children’s Hospital of Eastern Ontario, and has completed educational settings such as victimization, discrimination, bullying a pediatric residency at the Hospital of Sick Children in Toronto and the and the impacts of these on youth development, with a specific focus Children’s Hospital of Eastern Ontario. Behdad is a foreign trained who on LGBTQ youth. Anne-Marie is also interested in restorative justice moved to Canada in 2012 after completion of medical school training at and social-emotional learning as means for the promotion of positive Iran University of Medical Science, Tehran, Iran, and pediatric residen- school cultures. cy at Tehran University of Medical Sciences, Tehran, Iran. As a clinician with great enthusiasm in research, Behdad has been privileged, over Lindsay Peace above all, is the proud mother of three boys, the past 2 years, to work under supervision of Dr. Lawson, Co-Director one of whom is transgender. She is a fierce advocate for trans youth of CHEO’s Diversity Clinic and Co-Principal Investigator of Trans Youth and her actions in the field have attracted national and international Can!, to study hormonal treatments of trans youth. attention. She’s been actively involved in changing the dialogue, practices and policies within a wide scope of organizations from Amelia Marie Newbert is a passionate transgender and Alberta Health Services to the Calgary Board to Education among LGBTQ2+ advocate. She has served as the co-president of the Trans many others. Lindsay is the Director, Community Programs - Skipping Equality Society of Alberta, Director of Community Development Stone. with Calgary Pride and chairperson of Fierte Canada Pride’s national Stand4Trans initiative among others. She was also awarded the inaugural Grand Heart Award for outstanding and distinguished contribution to advancing LGBTQ2+ rights in Calgary. Amelia is the executive director of Skipping Stone. 81 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Yasmeen Persad is a trans woman of colour originally from the Daphne Prophète est détentrice d’un baccalauréat en scienc- Caribbean. She is a Trans Education and Training Facilitator for The 519. es de l’Université de Montréal et d’un diplôme d’études collégiales en She has been providing education and training around LGBTQ related soins infirmiers du Collège de Maisonneuve. Elle a également complété issues for the past 10 years. Her experience ranges from working with avec succès un microprogramme de 2e cycle en pratique avancée Trans Youth, HIV Positive Women, Sex Workers to many other diverse en soins de plaies de l’Université de Sherbrooke. Elle cumule plus de populations. She provides training to front- line workers (housing, 18 années d’expérience dans le réseau de la santé et des services corrections, etc.) around Trans community inclusion and support sociaux dans des secteurs cliniques diversifiés notamment en chirurgie and ran a group called the Trans Sex Worker Empowerment Project cardiaque, soins intensifs, médecine-chirurgie et les soins à domicile. (TSWEP) and now runs a group called Trans People of Colour (TPOC). Elle occupe depuis avril 2018 le poste de conseillère clinicienne et Yasmeen has led and participated in several research projects focused développement organisationnel au Centre Métropolitain de Chirurgie. on advancing Trans health, including Trans PULSE, The Trans Priorities Elle analyse, planifie et coordonne les activités cliniques et de recher- Project: Cross Country Trans Women and HIV Priority Setting, and the che reliées à la clientèle trans et est responsable de la dispensions des Canadian HIV Women’s Sexual and Reproductive Health Cohort Study formations tant internes qu’externes. (CHIWOS). Yasmeen has presented at many universities across North America on various topics about access for Trans people. She has been Daphne Prophète holds a Bachelor of Science from the part of ground-breaking recognition of trans women as women in the University of Montreal and a Diploma in Nursing from Collège de Mai- Violence Against Women sector. sonneuve. She has also successfully completed a graduate program in advanced practice wound care at the University of Sherbrooke. She Alex Pershai is a researcher, diversity and inclusion specialist. has more than 18 years of experience in the health and social services They specializes in gender, language, ethnicity, diaspora and minority network in a variety of clinical sectors, including cardiac surgery, issues. Pershai consults, facilitates workshops and advocates about intensive care, medicine, surgery and home care. Since April 2018, gender diversity, non-binary inclusion and gender- biased violence she has held the position of Clinical Consultant and Organizational prevention for international development and non-profit initiatives. Development at the Metropolitan Surgical Center. She analyzes, plans Pronouns: He (Him) / They (Their) and coordinates clinical and research activities related to trans clients and is responsible for internal and external training courses. Jade Pichette is the Manager of Programs at Pride at Work Canada. They work with some of Canada’s largest employers to Annie Pullen-Sansfaçon (Ph.D. Ethics, Social Work) is build workplaces that celebrate all employees regardless of gender a Full Professor of Social Work at the University of Montreal and the expression, gender identity, and sexual orientation. Jade has previously holder of the Canada Research Chair on transgender children and their worked at the Canadian Lesbian and Gay Archives, Kind Space, as an families. Since 2010, she has focused an increasing amount of her independent consultant, and was one of the founders of Trans Youth research time on various projects aimed at better understanding the Ottawa. experience of trans youth and their families. She is the co-author of the book “Supporting Trans and Gender Creative Youth: Schools, Families, Bruce Pipher Dr. Bruce Pipher is an Assistant Clinical Professor and Communities in Action” (Peter Lang, 2014 and revised edition in with the University of British Columbia in the department of psychiatry 2018) and is one of the co-founders of Gender Creative Kids Canada, and Clinical Director of the Interior Health Children’s Assessment a Montreal-based community organization working with trans children Network. He has been practicing and teaching in the field of and youth and their families. developmental psychiatry for over 20 years working collaboratively on a number of mental health initiatives both provincially and nationally. Annie Pullen-Sansfaçon (Ph.D éthique, travail social) Dr. Pipher provides mental health services to transgender youth in est professeure titulaire à l’École de travail social de l’Université de the Interior of BC and working with Transcare BC on supporting the Montréal et titulaire de la Chaire de recherche du Canada sur les development and coordination of youth and family friendly services enfants transgenres et leurs familles. Depuis 2010, elle a consacré throughout the BC. une grande partie de son temps de recherche à divers projets visant à mieux comprendre l’expérience des jeunes trans et de leurs Emery Potter is a non-binary nurse practitioner currently familles. Elle est coauteure du livre “Supporting Trans and Gender working in the Transition Related Surgery program at Women’s College Creative Youth: Schools, Families, and Communities in Action” (Peter Hospital. Prior to this, they worked at Sherbourne Health Centre for Lang, 2014 et édition révisée en 2018) et est l’une des cofondatices nearly a decade. Emery’ work has focused on a diverse range of issues de l’organisme Enfants transgenres Canada, un organisme including HIV, mental health, homeless care and hepatitis C. Emery communautaire basé à Montréal travaillant avec les enfants et les has been working to improve trans peoples access to quality health jeunes trans et leurs familles. care and has engaged in many activities to this end such as building primary care capacity through training and the development of learning Jake Pyne Jake Pyne is a Banting Postdoctoral Fellow at tools and mentorship. Re.Vision: The Centre for Art and Social Justice in the College of Social and Applied Human Sciences at the University of Guelph. As an advocate and researcher in Toronto’s trans community for the past 18 years, he has worked alongside many fine people to create trans access to emergency services, health care and family law justice, as well as to build community-based support for gender independent

82 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA kids and trans youth. Jake’s current research is titled “Dis/human Joe Raiche Dr. Joe Raiche is a psychiatrist and clinical assistant Others” and focuses on the intersection of autistic and trans life and professor at the University of Calgary. Since his involvement in the will soon become a partnership with a team of autistic and trans co- creation of two specialized gender clinics in 2014, he continues to researchers. In 2020 he begins a position as Assistant Professor in work with both the adult and youth trans populations at Foothills the York University School of Social Work. Medical Centre and Alberta Children’s Hospital in Calgary, AB. His main clinical focus is providing care for trans and gender non- Dr. Jake Pyne est boursier postdoctoral Banting chez Re.Vision conforming individuals who require support during their social : Le Centre for Art and Social Justice de l’Université de Guelph. Au and medical transition, and for those interested, connection with cours des 18 dernières années, Jake a travaillé sur une variété de hormones and gender-affirming surgeries. His clinical work also projets de recherche et de plaidoyer au sein de la communauté extends to educating medical students, residents, and practicing transgenre de Toronto, y compris : des efforts pour créer l’accès à des physicians on improving access and quality of care for trans patients. refuges d’urgence, à des services antiviolences, aux soins de santé This has resulted in significant curriculum changes at the Cumming et à la justice familiale. Il a également fait des contributions pour School of Medicine and collaborating on national CME projects aimed renforcer le soutien aux enfants et jeunes transgenres indépendants. at family physicians. His advocacy also manifests at a community Dans son étude doctorale récente, Jake s’est intéressé à la génération level by devoting time to participate in LGBTQ-affirming radio présente de jeunes transgenres et s’est demandé comment leur programing, documentaries, and local events/charities. avenir est bien pensable à cette époque et dans ce lieu. Ses recherches postdoctorales en cours portent sur l’intersection de Lindsay Reddeman MD, MSc (C) (she/her) l’autisme et de la vie transgenre. En 2020, Jake occupera un poste de Lindsay Reddeman is a resident physician in paediatrics at the professeur adjoint à l’École de service social de l’Université York. University of Toronto and the Hospital for Sick Children, and a Master’s student at the Institute for Health Policy, Management, and Evaluation at the University of Toronto. Prior to that, she worked as a R management consultant for a large global consulting firm, and as an analyst at Cancer Care Ontario driving initiatives to improve treatment Marjorie Rabiau, Ph.D. is an Assistant Professor in the School access and quality for patients. Through her Master’s program, she of Social Work at McGill University. She is one of the core faculty has had the opportunity to work with the Transition-Related Surgeries teaching in the specialization Masters in Couple and Family Therapy. (TRS) Program at Women’s College Hospital, where she has focused Dr. Rabiau is a registered clinical psychologist and a couple and on analyzing the clinic referral process and assessing referral patterns family therapist. Dr. Rabiau is affiliated with the McGill University to identify opportunities to improve access to TRS for patients. She Sexual Identity Center, doing clinical supervision as well as running has a strong interest in health advocacy, policy and systems planning; groups for parents of transgender and gender creative youth using an increasing access to gender care; and gender care for youth. affirmative model of care. Bertrand Riff MD, Médecin généraliste à la Maison Dispersée Asa Radix MD, MPH, FACP Dr. Radix is the Senior Director de Santé. La Maison Dispersée de Santé est une maison médicale of Research and Education and a Clinical Associate Professor engagée dans les problématiques sociétales( IVG,VIH, toxicomanie, of Medicine at New York University. Dr. Radix trained in internal parentalité, transidentité). Enseignant au pole universitaire de medicine and infectious diseases at the University of Connecticut médecine générale de Lille. Pdt du COREVIH Haut de France. and completed postgraduate qualifications in tropical medicine and public health in the United Kingdom. Dr. Radix has over 20 Bertrand Riff MD, is a general practitioner at the Maison years of experience providing primary care and hormone therapy to Dispersée de Santé. La Maison Dispersée de Santé is a medical transgender and gender non-binary people and is a recognized expert centre committed to social issues (abortion, HIV, drug addiction, in transgender medicine. Dr. Radix is currently co-chair of the World parenthood, trans identity). Dr. Riff is also a lecturer in general Professional Association of Transgender Health (WPATH) Standards medicine the university campus in Lille and the president of COREVIH of Care revision committee and serves on the WPATH and USPATH Haut de France boards. Dr. Radix is Associate editor of Transgender Health and on the editorial board for the International Journal of Transgenderism. Kaleb Robertson (he/him), is a Cultural Hustler based Pronouns: They/He in Toronto. He is a queer, trans, and body positive activist who produces and hosts events, DJs, and does workshops and speaking Asa Radix MD, MPH, FACP Dr. Radix is the Senior Director engagements. His alter ego, Fluffy Soufflé (they/them) is half of of Research and Education and a Clinical Associate Professor the magical storytelling duo, Fay & Fluffy’s Storytime, who have of Medicine at New York University. Dr. Radix trained in internal been doing drag storytimes for three years, and have engaged with medicine and infectious diseases at the University of Connecticut thousands of families promoting the joy of diversity and literacy. and completed postgraduate qualifications in tropical medicine and public health in the United Kingdom. Dr. Radix has over 20 Amy Robinson MD, FRCPC, CHEO Research Institute, Division years of experience providing primary care and hormone therapy to of Adolescent Health, Department of Pediatrics, CHEO, University of transgender and gender non-binary people and Pronouns: They/He Ottawa to come

83 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Anna Rogers, Clinical Endocrinologist with the Division of Kaeden Seburn (They/Them/He pronouns) is nonbinary, trans- Endocrinology and Metabolism at the University of Alberta and Division masculine white settler, a bachelor of social work student at Carleton of Endocrinology Lead for the Gender Program. Completed medical University and a trans community organizer, activist and educator school at the University of Calgary and moved back home to Edmonton from unceded Algonquin territory. They are a founder and facilitator for Internal Medicine and Endocrinology sub-specialty training. of Support and Education for Trans Youth (SAEFTY Ottawa), Ottawa’s only by and for trans youth group, and a trans health advocate in the Champlain Region and across Ontario. Their work focuses primarily S on the de-pathologization of trans identities and on ensuring that trans, nonbinary and gender diverse youth have access to health care, Elizabeth Saewyc, PHD, RN, FSAHM, FCAHS, FAAN, is schools and social services that are affirming and allow them to main- Professor and the Director of the School of Nursing at the University tain autonomy over their bodies, lives and identities. You can find them of British Columbia in Vancouver, Canada; she also leads the online at kaedenseburn.com. multidisciplinary Stigma and Resilience Among Vulnerable Youth Centre. For more than 20 years, Dr. Saewyc’s research and clinical Laura Shiels is the LGBTQ2S+ Natural Supports Worker at practice as a public health nurse has focused on health equity for Centre for Sexuality where she works with youth and their families to marginalized youth, especially for lesbian, gay, bisexual, transgender, enhance natural supports during the coming out process. Laura holds queer, and Two Spirit (LGBTQ2S) adolescents. Her research and a Bachelor of Arts in Communications and Women’s Studies. She has public health nursing practice has focused on how stigma, violence, been working in the field of Sexuality for over ten years. She hosts a and trauma influence adolescents’ health and coping behaviours, and monthly support group for parents of gender creative kids, volunteers what protective factors can foster resilience and improve health equity annually at Camp fYrefly Calgary, and has developed and delivered, for marginalized young people, especiallyLGBTQ youth, homeless, non-judgmental LGBTQ2S+ health programs for youth and families. runaway and street-involved adolescents, sexually abused/exploited teens, immigrants and refugees, and Indigenous young people in Adrienne Smith is a transgender human rights activist and drug several countries. She was lead investigator for the first federally policy lawyer. They recently settled a BC Supreme Court case which funded Canadian Trans Youth Health Survey in 2013- 2014, and has guaranteed access to opiate replacement therapy for prisoners in BC just launched the repeat survey 5 years later. She is a Fellow in the jails. Adrienne appeared at the BC Court of Appeal and the Supreme Society for Adolescent Health and Medicine, in the Canadian Academy Court of Canada where they argued about the deleterious effects of of Health Sciences, and in the American Academy of Nursing. She is mandatory minimum sentences for women, indigenous people, and also the Executive Director at Stigma and Resilience Among Vulnerable drug users. At the CLC, they advocate for transgender inclusion in our Youth Centre (SARAVYC) unions and workplaces. Adrienne volunteers at the Catherine White Holman Wellness Clinic where they give free legal advice and notarize Elizabeth Saewyc Ph.D., IA, FSAHM, FCAHS, FAAN, est name change documents for trans people. professeure et directrice de l’École des sciences infirmières de l’Université de la Colombie-Britannique à Vancouver, Canada. Elle Julia Sorbara is a staff endocrinologist at the Hospital for Sick dirige également le centre multidisciplinaire Stigma and Resilience Children where she is a provider in the Transgender Youth Clinic. Her Among Vulnerable Youth Centre. Depuis plus de 20 ans, la recherche research in this area has focused on identifying factors that influence et la pratique clinique de la Dre Saewyc en tant qu’infirmière en santé when transgender youth present to medical care as well as mental publique sont axées sur l’équité en santé pour les jeunes marginalisés, health implications of delayed presentation to care. en particulier les adolescents lesbiennes, gais, bisexuels, transgenres, queer et bispirituels (LGBTQ2S). Sa recherche et sa pratique des soins Katie Stadelman Social Worker-MSW, graduated from the infirmiers en santé publique ont porté sur la façon dont la stigmatisation, University of Toronto Faculty of Social Work in 2012. Since this time la violence et les traumatismes influencent la santé des adolescents et she has been working as a clinical social worker at Sick Kids Hospital leurs comportements d’adaptation. De plus, sa recherche vise à évaluer in the Division of Adolescent medicine and Department of Psychiatry. les facteurs de protection qui peuvent favoriser la résilience et améliorer She is one of the founding members of the Transgender Youth Clinic at l’équité en santé des jeunes marginalisés, particulièrement : les jeunes Sick Kids. Prior to this she worked within the developmental services LGBTQ, les sans-abris, les jeunes fugueurs, les adolescents de la rue, les and education sectors. Her areas of interest include supporting and adolescents victimes de violence sexuelle, les immigrants et réfugiés, les advocating for youth experiencing gender dysphoria, adolescent jeunes Autochtones de divers pays. Elle a été la chercheuse principale psychiatry, and school avoidance. de la première Sondage sur la santé des jeunes transgenres canadiens financé par le gouvernement fédéral en 2013- 2014, et elle vient tout Ále Suárez is an education and support worker with the Gender juste de lancer le nouveau sondage cinq ans plus tard. Elle est membre Journeys program as well as an expressive arts therapist and musician. de la Society for Adolescent Health and Medicine, de l’Académie cana- They work with the trans community, at risk youth, women escaping dienne des sciences de la santé et de l’American Academy of Nursing. violence and a variety of other populations. He infuses the arts to create Elle est directrice générale du SARAVYC (Stigma and Resilience Among connection and self-expression through various modalities of art in Vulnerable Youth Centre). his facilitation. Ále believes the arts speak the language of the soul, which gives us direct access to our most authentic selves. She has worked with KW Counselling, The Emily Murphy Centre, Sheena’s place among many other organizations. Ále currently works with the Gender

84 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Journeys program through the Canadian Mental Health Association in fy within the LGBTQ umbrella, particularly transgender and gender di- Peterborough, ON. They facilitate groups for trans and questioning verse youth. Her research interests are focused on highlighting social folks and their loved ones. We provide one on one support as well justice as it relates to cultural factors and identities, and developing as education and training to local organization on how to best serve better understandings of individuals across the many intersections of the trans community.Ále is a Venezuelan-American who has been identity, including ethnicity and gender. Sulin is currently a provisional residing in Canada for the last 6 years. He identifies as non-binary, psychologist based in Edmonton, Alberta. genderqueer and gender nonconforming and uses they, he and she pronouns. Andrée-Anne Talbot, MD. is a family physician with a degree from the University of Montreal. She has been following Frank Suerich-Gulick Ph.D is a Research Professional at transgender and non-binary people in Montreal using an informed the University of Montreal School of Social Work. He has been acting consent approach since 2013, and works in hospitalization at Barrie as the Research Coordonator for the project Stories of Gender Affirning Memorial Hospital in Ormtown. Care (CIHR 2016-2019) Ken Tang, Dr., Clinical Research Unit, CHEO Research Institute, Tanya Surette, PhD, MOC, is a Registered Psychologist Children’s Hospital of Eastern Ontario, Ottawa, Ontario practicing in Southern Alberta, and a sessional instructor for the University of Calgary, Werklund School of Education. She specializes Ashley Taylor, is a graduate of the Iowa State University Human in psychoeducational assessment, consultation with school Development and Family Studies Ph.D. program. Her dissertation districts around the inclusion of exceptional learners, and clinical research utilized a quantitative approach to examine the role of harsh supervision. Her research interests include investigating the effects of parenting, interparental conflict, and microaggressions on perpetration heteronormativity in school settings, and clinical practice with post- and victimization of psychological intimate partner violence and (2) secondary students. the role of family support, family rejection, and microaggressions on sexual identity development among LGBTQ+ college students. As Françoise Susset is a clinical psychologist and couple and a Postdoctoral Research Fellow at SARAVYC, Ashley is leading the family therapist. Her current focus is working with gender diverse Canadian Trans Youth Health Survey and will work on various projects children, youth and their families, and helping schools challenge related to LGBTQ+ well- being and supportive school and community notions regarding sexuality, sexual orientation, gender identity and environments. Outside of academia, Ashley is a research consultant gender expression. Françoise is responsible for the training and for the Human Rights Campaign where she has assisted with various clinical supervision of a great number of clinicians across Canada projects including the report A Time to Act: Fatal Violence Against wishing to integrate transgender health in their practice. She teaches Transgender Peoplein America and the 2018 U.S. LGBTQ Paid Leave in the McGill University M.A. program in Couple and Family therapy. Survey. Françoise is past president of the Canadian Professional Association for Transgender Health (CPATH). Julie Temple Newhook Dr. Julie Temple-Newhook is a Professional Associate in the Janeway Pediatric Research Unit of Françoise Susset est psychologue et thérapeute conjugale the Faculty of Medicine, and a Visiting Assistant Professor in the et familiale avec plus de 25 ans d’expérience dans le travail auprès Department of Sociology at Memorial University. She founded and des individus, des couples et des familles LGBT. Elle s’intéresse tout co-facilitates the national and local peer support groups, Canadian particulièrement à l’évaluation et au suivi clinique des adultes et des Parents of Trans & Gender Diverse Kids / Parents canadiens d’enfants adolescentes trans, durant et au-delà de la transition. Elle est spé- trans, and Parents of Trans & Gender Diverse Kids – Newfoundland & cialisée également dans le soutien aux familles dont l’enfant exprime Labrador. She also helped to found the Trans Youth Group, a support son genre de manière non normative (gender expansive children) afin group for trans youth aged 12-18 years in St. John’s, and partnered d’aider les familles et les écoles à remettre en question des notions with Echo Pond Summer Camp to offer Camp Rainbow, the first associées à la sexualité, l’orientation sexuelle, l’identité de genre et summer camp in NL for trans and gender diverse children aged 7-15 l’expression de genre. Elle enseigne dans le programme de thérapie years. She is a member of the Trans Needs Committee at Memorial, conjugale et familiare de l’Université McGill. Elle est membre de la the Trans Health Committee of Eastern Health, and the Canadian WPATH et ancienne présidente de CPATH. Professional Association for Transgender Health.

Oliver Thorne (He/Him pronouns) is a transmasculine white T settler currently living on unceded, unsurrendered Algonquin territory pursuing his undergrad at Carleton in Indigenous and Canadian studies and minoring in political science. He is a facilitator of Support Sulin Tan recently obtained her Doctor of Clinical Psychology and Education for Trans Youth (SAEFTY Ottawa). SAEFTY is the only degree from Adler University (Vancouve, r). Sulin completed her by and for trans youth group in Ottawa and is focused on community pre-doctoral internship at the Counselling & Clinical Services at the events and trans health advocacy. The need for de- pathologization of University of Alberta, where she provided therapy and consultation trans identities and access to health care that allows for bodily auton- services to university students and staff on an array of mental health omy of trans, non-binary and gender diverse youth are at the center topics, including mood and anxiety disorders and trauma. Her clinical of Oliver’s work with SAEFTY. Oliver is passionate about politics and training has included providing assessment, and individual- and group-based interventions to adolescents and young adults who identi- challenging the status quo. 85 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Nicole Thompson Dr. Nicole Thompson graduated from the University of Calgary Cumming School of Medicine in June 2019 and V has since started her residency in Obstetrics and Gynecology at the University of British Columbia. Prior to medical school, she worked Chloe Viau Âgée de 70 ans, Chloé Viau est une activiste pour la as an occupational therapist and case management practice lead for défense des droits des personnes LGBTQ+. Femme transgenre, elle a Alberta Health Services and as a sessional instructor for the University vécu pendant 64 ans dans le mauvais corps. Non sans difficulté, elle a of Alberta Faculty of Rehabilitation Medicine. During medical school, entrepris sa transition en 2016, ce qui a eu pour effet d’améliorer son Dr. Thompson was involved in several student- led quality improvement bien-être, fierté et estime de soi. Chloé est une pionnière des enjeux initiatives including authorship of gender affirming care curriculum trans pour les personnes aînées et elle lutte contre l’homophobie content. The content was developed in partnership with gender diverse et la transphobie chez les aînés LGBTQ+. Elle siège sur le conseil community members to ensure that the priorities of the community d’administration d’Enfants Transgenres Canada depuis 2019. were well represented. The content was officially adopted by the University of Calgary in September 2018 and will continue to be a Chloe Viau is an advocate of 70 years old that fights for the rights part of the medical school curriculum going forward. In addition to of LGBTQ + communities. She is a trans woman who lived for 64 years her work at the local level, Dr. Thompson has also initiated a Canada- in the wrong body. Not without difficulty, she began her transition in wide Delphi study with the goal of developing a national strategy for 2016, which had the effect of improving her well-being, pride and how undergraduate medical institutions engage students and staff in self-esteem. Chloe is a trans pioneer for seniors and fights against gender-affirming care and transgender medicine. homophobia and transphobia among LGBTQ + seniors. She sits on the Board of Gender Creative Kids Canada since 2019. Nicole Todd, Dr. Nicole Todd, LGBTQ2SIA+ Health Curriculum in Canadian Obstetrics & Gynecology Residency Programs, Pediatric and Evan Vipond, is a Ph.D. Candidate in Gender, Feminist and Adolescent Gynaecologist, University of British Columbia, Vancouver, Women’s Studies at York University. Evan’s work is interdisciplinary, British Columbia and engages with critical trans theory, feminist theory, critical race theory, political economy, and cultural studies. As a researcher, Evan Dr. Marria Townsend, Physician, is the Medical Director designed and conducted the TTCP needs assessment. They also serve of Trans Care BC, a program of the Provincial Health Services as a Board Member member for JusticeTrans, a website dedicated to Authority. She is fortunate to live and work as an uninvited guest on providing up-to-date information on trans rights in Canada. the ancestral, traditional and unceded territory of the xʷməθkwəy̓ əm Alice Virani, MA (Oxon), MS, MPH, PhD, is the Director of the (Musqueam), Skwxwú7mesh (Squamish), and Tsleil-waututh Nations. Clinical Ethics Service for the Provincial Health Service Authority of Marria completed her medical school and residency training at UBC BC. Her clinical work focusses on paediatric bioethics, from both where she is currently Clinical Assistant Professor in the Faculty of an organizational and clinical perspective. She is a Clinical Assistant Medicine, Department of Family Practice. She has over a decade of Professor in the Department of Medical Genetics at UBC and teaches clinical experience serving transgender and gender diverse patients in bioethics in a number of graduate, clinical and public settings. Her her practice at Three Bridges Community Health Centre in Vancouver. research interests relate to the many ethical issues inherent within Marria is passionate about teaching and mentoring students, residents clinical practice and research in paediatric healthcare, particularly in and practicing clinicians to better enable them to provide quality, relation to marginalized and vulnerable youth as well as genetic and affirming care to this population. genomic medicine. She has published in a broad range of peer reviewed journals including Social Science and Medicine, the American Journal of Dalia Tourki works at the Centre for Gender Advocacy, and is a Human Genetics and the American Journal of Public Health. She has a board member of LGBTQ action with immigrants and refugees (AGIR). masters in Human Sciences from Oxford University, a masters in Genetic She coordinated two academic research projects: the first one on the Counseling from Sarah Lawrence College, a masters in Public Health experiences of trans youth aged between 18 and 25 years old, and the from Columbia University, and a PhD in Genetics and Ethics from UBC. second is about the realities of racialized LGBTQ migrants. She gives dozens of workshops on trans issues, and recently spearheaded a trial Serena Visser, MSW, RCSW, is an instructor at the University against the government of Quebec at the superior court. The trial seeks of Calgary, Faculty of Social Work, Southern Alberta Region. A second to invalidate 11 provisions of the Civil Code of Quebec that prevent the year PhD student in Cultural, Social, and Political Thought at the full participation of trans people in civil society. She is the co-author of University of Lethbridge, Serena’s research at the intersection of gender two recently-published academic articles. studies and mental health aims to trouble, theorize and give meaning to the institutional practices that shape interactions for trans and gender Dalia Tourki travaille au Centre de lutte contre l’oppression diverse individuals accessing mental health services. des genres et fait partie du C.A. d’Action LGBTQ avec Immigrant.e.s et Réfugié.e.s (AGIR). Elle a coordonné deux projets de recherche académique : l’un sur les expériences des jeunes trans âgées entre 18 et 25 ans, et l’autre sur les réalités des personnes LGBTQ migrantes et racisées. Elle donne des dizaines de conférences sur les enjeux trans, et a récemment mené un procès contre la Procureure Générale du Québec. La poursuite cherche à invalider 11 articles du Code Civil qui empêchent la pleine participation des personnes trans dans la société civile. Elle est l’auteure de deux articles académiques, récemment publiés. 86 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

W Sebastian Westerlund, (he/they) is the queer and trans outreach coordinator for KONTAK, organizing events and programming for MSM communities around drug use, kinky queer sex, and harm re- Raphaël Wahlen, M.D., est médecin pédiatre, suisse. Il a duction. He is a queer trans guy who has been involved in outreach and travaillé dans la Division de Santé pour Adolescents de Lausanne. En activism for many years with gay, bi, trans, poly, and kink communities. 2018, il vient à Montréal dans le cadre d’un stage de 2 ans au centre Recently graduated with a Bachelor’s of Social Work from McGill Univer- de santé Meraki et à l’Hôpital de Montréal pour Enfant avec l’intention sity, Seb has worked as an intern at Project 10 and ASTT(e)Q, doing peer de se former spécifiquement en santé des adolescents transgenres. support and advocacy for trans and queer youth. He also has experience A côté de la pratique clinique, il réalise un projet de recherche sur as a board member at P10, working towards anti-racism and anti-oppres- l’expérience des médecins dans la prise en charge des adolescents et sion on an institutional as well as personal level. He is passionate about jeunes adultes non-binaires. the health, empowerment and well-being of trans folks and loves to work with and for queer or trans men who love to get nasty. Raphaël Wahlen, M.D., is a Swiss paediatrician. He worked in the Health Division for Adolescents in Lausanne. In 2018, he came Robin Westmacott, is a registered psychologist and an to Montreal for a 2-year internship at the Meraki Health Centre and assistant professor in the Department of Clinical Health Psychology the Montreal Children’s Hospital to train in the field of transgender in the Max Rady College of Medicine at the University of Manitoba. adolescent health. In addition to his clinical practice, he is conducting She received a Ph.D. in clinical psychology from the University of a research project on the experience of physicians treating non-binary Ottawa, Canada. She teaches emotion-focused therapy to practicum adolescents and young adults. students and residents in clinical psychology, and teaches modules in psychological aspects of patient care to undergraduate medical Jaisie Walker (they/them) is a Masters of Arts student in Women students. She works on a multidisciplinary team in a transgender health & Gender Studies at the University of Lethbridge, interested in: queer clinic in Winnipeg. theory; anti-violence; mutual aid and collective governance; restorative justice and prison abolition; and visual pedagogies. Their current Erin Wisman, is a family physician at Virginia League for Planned community-based project, funded by research awards from the Social Parenthood. Erin is the primary care physician involved in programmat- Sciences and Humanities Research Council (SSHRC) and Alberta’s ic outreach and oversight for the primary care services to patients aged Parkland Institute, uses PhotoVoice to look at experiences of violence in 16-90, including hormone therapy at the clinic. She and her team have rural LGBTQA2S+ Non-Monogamous communities. Outside of academia, provided over 2000 transgender patient health services in 2018. Jaisie works as the President for OUTreach- Southern Alberta’s only LGBTQA2S+ non-profit, and as Co-Chair for PSVAC- an on-campus is a teacher and workshop facilitator living and committee for anti-sexual violence action and advocacy. Jaisie has held Chris Wolff, working on unceded Coast Salish territory (Vancouver, BC). Chris works previous roles in board leadership and community education through with trans and gender-diverse folks of all ages in different community organizations such as the Campus Women’s Centre, Lethbridge Public organizations and is passionate about improving access and services Interest Research Group, and Safe Haven Women’s Shelter Society. for LGBTQ2S+ folks. Pronouns: He/him/his, they/them/ theirs Tracy Wong, completed her Hons. B.Sc (High Distinction) and M.Ed Thea Weisdorf, MD, FCFP Assistant Professor University of at the University of Toronto. She is now pursuing her PhD in Human Toronto, Family Physician at St. Michael’s Hospital Academic Family Development at McGill University. In the past, Tracy served as a Health Team, Faculty Development Lead DFCM SMH. research assistant at the Chinese University of Hong Kong and the Polytechnic University of Hong Kong, respectively examining parent- Kristopher Wells, is an Associate Professor in the Department child relationship and positive youth development. She also has a few of Child and Youth Care, Faculty of Health and Community Studies years of teaching experience as a part-time teacher for kindergarten, at MacEwan University. His scholarly work specializes in sexual and primary and secondary school students in Hong Kong. Tracy’s research gender minority youth, health, education, and culture. Dr. Wells is one focuses on socio-emotional and cognitive development within the of the driving forces behind the creation of many ground- breaking context of parenting, exploring topics such as attachment and emotion initiatives including Camp fYrefly, PrideTape, and NoHomophobes. com, socialisation. She is also interested in examining the link between the which has been featured across the world in more than 50 publications school climate and various student outcomes, including academic including the Economist, Atlantic, Independent, and Guardian. Dr. Wells achievement, bullying, and peer relationship. Currently, Tracy is actively is a frequently invited national and international speaker on sexual and recruiting participants in Canada and Hong Kong for her doctoral gender minority youth issues. He has served as an expert scientific dissertation, examining associations among parental socialization consultant to the Federal Government of Canada, Canadian Senate, of values, prosocial behaviours, academic achievement, and peer Canadian Museum of Human Rights, Canadian Teachers’ Federation, relationships. Tracy’s overarching goal is to conduct research that can RCMP, Public Health Agency of Canada, UNESCO, World Health effectively inform parenting programs and school-based interventions. Organization, and many provincial and municipal governments across Canada. Currently, Dr. Wells serves as the Co-Editor of the International Tracy Wong, completed her Hons. B.Sc (High Distinction) and Journal of LGBT Youth, which is the world’s leading research publication M.Ed at the University of Toronto. She is now pursuing her PhD in on LGBT youth. His early career work has been recognized with over 50 Human Development at McGill University. In the past, Tracy served as scholarly and community awards and recognitions including the Alberta a research assistant at the Chinese University of Hong Kong and the Teachers’ Association’s Public Education Award, University of Alberta’s Polytechnic University of Hong Kong, respectively examining parent- Alumni Horizon Award, and an Alberta Centennial Medallion. 87 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA child relationship and positive youth development. She also has a few years of teaching experience as a part-time teacher for kindergarten, Z primary and secondary school students in Hong Kong. Tracy’s research focuses on socio-emotional and cognitive development within the Erin Ziegler is a nurse practitioner and completed her doctoral context of parenting, exploring topics such as attachment and emotion work at McMaster University. Her clinical and research interests include socialisation. She is also interested in examining the link between the the LGBTQI2S population. Her doctoral work examined the delivery and school climate and various student outcomes, including academic implementation of primary care services for transgender individuals in achievement, bullying, and peer relationship. Currently, Tracy is actively Ontario. Erin is the recipient of the McMaster Nursing Graduate Program recruiting participants in Canada and Hong Kong for her doctoral Research Awards, McMaster School of Nursing Academic Excellence dissertation, examining associations among parental socialization award, a TUTOR-PHC fellowship and a CIHR award. of values, prosocial behaviours, academic achievement, and peer Sue Zinck Dr. Sue Zinck is an Assistant Professor of Psychiatry at relationships. Tracy’s overarching goal is to conduct research that can Dalhousie University and a staff Psychiatrist at the IWK Health Centre. effectively inform parenting programs and school-based interventions. She received her M.D. from Dalhousie in 1998 and completed both her Psychiatry residency in 2004 and fellowship in Child and Adolescent Nancy Wright M.S.W. currently works at the IWK Health Centre Psychiatry in 2005, at the McGill University Health Centre. Dr. Zinck with the Community Mental & Addictions program as a clinical social became an inaugural fellow of the RCPSC in Child & Adolescent worker on the Trans Health Team. With over 20 years of experience, Psychiatry in 2013. She is the physician leader at the IWK Bipolar she is a strong advocate for LGBTQ2S community. In 2006, Nancy Disorders clinic & at the Halifax branch of the IWK Community Mental co-founded the Trans Health Team at the IWK to address the needs Health Clinic. She is the physician leader of the IWK Transgender Health of trans* and gender-diverse youth. The team provides mental health Team and with this team, led the development of a provincial supervision assessment, support with gender dysphoria, and referrals to transition network for child & youth health care providers. Dr. Zinck teaches and services as needed. Nancy is now committed to building capacity among supervises medical students, pediatric and psychiatry residents and her peers by developing and providing training to ensure treatment and fellows in child & adolescent psychiatry. Dr. Zinck also teaches psychiatry education resources will continue to exist for trans* youth. Nancy also residents core CBT skills and led the redevelopment of the Sexuality co-leads with another social worker, a community- based group, ‘Listen. curriculum in the Faculty of Medicine’s Human Development Unit. Share. Connect’ for parents of trans* and gender-diverse youth. She also supervises other clinicians from across Nova Scotia as a member of the Sue Zinck Dr. Sue Zinck is an Assistant Professor of Psychiatry at child & youth trans* health care provider network. Dalhousie University and a staff Psychiatrist at the IWK Health Centre. She received her M.D. from Dalhousie in 1998 and completed both her Psychiatry residency in 2004 and fellowship in Child and Adolescent Y Psychiatry in 2005, at the McGill University Health Centre. Dr. Zinck became an inaugural fellow of the RCPSC in Child & Adolescent Psychiatry in 2013. She is the physician leader at the IWK Bipolar Christina Yager Registered Social Worker (OCSWSSW) holds a Disorders clinic & at the Halifax branch of the IWK Community Mental Master of Social Work from the University of Toronto and a Bachelor of Health Clinic. She is the physician leader of the IWK Transgender Health Arts and Certificate in lesbian, gay, bisexual and transgender studies Team and with this team, led the development of a provincial supervision from Queens’ University. She has been working at the Centre for Addic- network for child & youth health care providers. Dr. Zinck teaches and tion and Mental Health (CAMH) for 9 years, first in Rainbow Services supervises medical students, pediatric and psychiatry residents and and now in the Adult Gender Identity Clinic. She identifies as queer and fellows in child & adolescent psychiatry. Dr. Zinck also teaches psychiatry considers herself very fortunate to work with LGBTQ communities. residents core CBT skills and led the redevelopment of the Sexuality curriculum in the Faculty of Medicine’s Human Development Unit. Stephanie Young is a senior associate in the Toronto office of Borden Ladner Gervais LLP, practicing labour and employment, human Zachary Zytner is a clinical fellow in Pediatric Endocrinology at rights and accessibility law. She has appeared as employer and/or de- the Hospital for Sick Children and University of Toronto as of July 2019. fence counsel before the Superior Court of Justice, the Divisional Court, He trained as a resident in Pediatrics with the Northern Ontario School the Ontario Court of Appeal, the Ontario Human Rights Tribunal, the of Medicine in Sudbury, Ontario and Ottawa, Ontario from 2016-2019. Ontario Labour Relations Board, and at labour arbitrations. Stephanie has He completed medical school at Western University’s Windsor, Ontario advised and trained many employers and service providers on inclusivity campus in 2016. He was inspired to pursue Pediatrics after spending in the workplace, including as it relates to gender identity and expression. many of his formative years working with kids as a swim instructor. Zach worked with a number of trans and non-binary youth throughout residen- Ashleigh Yule is a registered psychologist specializing in child cy in Pediatrics and hopes to continue that work in his future practice. and adolescent mental health with a focus in LGBTQ+ issues, espe- cially transgender health. She provides counselling, assessment, and consultation services for children, adolescents, and their families. She also provides professional development and teacher education around child and adolescent mental health. She is a member of the Canadian Professional Association for Transgender Health (CPATH) and regularly works with gender creative children, transgender youth, their families, and their school teams.

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89 CPATH CONFERENCE 2019 - ADVANCING TRANS HEALTH AND WELL-BEING IN CANADA

Exhibitors CPATH 2019 Conference

CIHR Institute of Gender and Health www.cihr-igh.ca

Gender Creative Kids www.gendercreativekids.ca

SEX-ED + www.positivesexed.org

CAMH - Centre for Mental Health and Addictions www.camh.ca

GRS Montreal www.grsmontreal.com

McMaster University www.mcmaster.ca

Women’s College Hospital www.womenscollegehospital.ca

! TD Bank www.td.com/ca/fr/a-propos-de-la-td/la-promesse-a-agir/

Zapshalla Rusnak Financial Services Ltd www.sunlife.ca/barry.zapshalla/e/index.htm

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