Intransigent transactions

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This article was published 19/11/2024 (651 days ago), so information in it may no longer be current.

When Parker Morran saw a doctor in Steinbach in 2020 to discuss transitioning, the 31-year-old wasn’t provided care or compassion.

Instead, Morran, who uses they/them pronouns, says they got a “long rant” on how transitioning doesn’t align with Christianity.

“I just laughed at him and said, ‘This is a stupid thing to say to your patient,’” says Morran, who grew up in Kleefeld, a town of less than 2,000 people west of Steinbach.

“I know that I’m not the only person who he said things like that to.”

Morran was forced to travel to Klinic Community Health centre in Winnipeg, 70 kilometres away, to get treatment.

Queer advocates and experts say Morran’s experience isn’t uncommon and trans people don’t feel safe accessing health care in rural Manitoba.

Kaitlyn White, a co-ordinator for the Sexuality Education Resource Centre’s location in Brandon, says health-care providers in all areas of the province need training to create welcoming spaces for members of the queer community.

“It’s not just as simple as putting up a rainbow sticker in your window or office,” says White.

Morran, a trans social worker in Winnipeg, says trans people who grow up in rural areas face many barriers when seeking health care, such as having to travel long distances, under-educated caregivers and discrimination.

“You don’t know how safe you’re going to be at the clinic or hospital because those same people (providing care) might go to your church or they might be friends with your mom,” says Morran, who moved to the city in 2023.

This causes many trans people to avoid the health-care system because they’re scared of being outed, they say.

Morran became a social worker in 2018 after graduating from Booth College and working in Steinbach with Child Family Services. When a job opening came up at Klinic, they jumped at the chance to combine trans advocacy with a career.

In 2021, Morran joined the wait-list for top surgery at Klinic, a procedure that reduces breast tissue to make a person’s chest more masculine. They had to wait eight months for an intake appointment and had the surgery in 2023.

Klinic is the only dedicated facility in Manitoba to provide gender-affirming care. Currently, the wait for an intake appointment for trans health care is 10 months, Morran says.

The next best option outside of Winnipeg is the Trans Health Clinic in Brandon, which operates one day a month and has one doctor, as per the Prairie Mountain Health authority’s website.

In July, the provincial government announced it would reduce barriers to gender-affirming care by removing the need for two medical referrals and allowing more doctors and nurses to provide referrals for surgeries and hormone treatments.

While Morran sees the change as positive progress, many doctors aren’t willing to offer that care, they say.

A 2021 study by Brandon University found it’s common for queer people who live in rural Manitoba to experience discrimination and stigma when they seek gender-affirming care.

All 12 study participants said they were denied care by their doctor or nurse at some point, with doctors citing either knowledge gaps or personal beliefs as the reasons.

More needs to be done to improve health-care resources available to the rural queer community, says Nadine Henriquez, an associate nursing professor at Brandon University and co-author of the study.

Education about gender-affirming care much be improved and more investment in queer-friendly health care spaces can help close the existing gaps, she says.

“It’s an expectation for health-care professionals to identify their own knowledge gaps and seek out that knowledge, and not expect our patients to be the only ones educating us on trans health care,” says Henriquez.

If more doctors were willing to learn about trans health care with their patients, it would help rebuild trust with the community, Morran says.

“Doctors need to be comfortable getting up to date on standards of care for trans people and they need more training on what do you do when a trans person walks in the door,” Morran says.

A spokesperson for Doctors Manitoba called it distressing to hear patients have experienced discrimination and stigma in such cases.

Physicians have raised concerns to Doctors Manitoba about the lack of training, practice guidelines and long delays for gender-affirming care, says the spokesperson.

While Doctors Manitoba has helped promote several doctor training events through the Rainbow Resource Centre and Klinic, the spokesperson says more resources from the government are needed.

Health Minister Uzoma Asagwara says they understand the fears rural trans people have when accessing health care. The province’s push to recruit doctors and nurses, and the improved referral process, are important changes, they say.

“I will always stand on the side of all gender-diverse Manitobans having better health care. We’ve been very clear about that from Day 1,” Asagwara told reporters recently.

“We understand that there are concerns and experiences that folks are having that shouldn’t be happening.”

Asagwara didn’t provide details about what actions the government is taking to improve doctor and nursing training for gender-affirming care, or how it will increase resources for trans people in rural Manitoba.

fpcity@freepress.mb.ca