{"id":86278,"date":"2023-02-02T17:37:51","date_gmt":"2023-02-02T22:37:51","guid":{"rendered":"https:\/\/newsroom.carleton.ca\/?post_type=cu_story&#038;p=86278"},"modified":"2025-08-19T09:37:07","modified_gmt":"2025-08-19T13:37:07","slug":"telehealth-cuts-trans-non-binary-people","status":"publish","type":"cu_story","link":"https:\/\/carleton.ca\/news\/story\/telehealth-cuts-trans-non-binary-people\/","title":{"rendered":"Cuts to telehealth in Ontario mean fewer trans and non-binary people will have access to life-saving health care"},"content":{"rendered":"\n<section class=\"w-screen px-6 cu-section cu-section--white ml-offset-center md:px-8 lg:px-14\">\n    <div class=\"space-y-6 cu-max-w-child-max  md:space-y-10 cu-prose-first-last\">\n\n        \n                    \n                    \n            \n    <div class=\"cu-wideimage relative flex items-center justify-center mx-auto px-8 overflow-hidden md:px-16 rounded-xl not-prose  my-6 md:my-12 first:mt-0 bg-opacity-50 bg-cover bg-cu-black-50 pt-24 pb-32 md:pt-28 md:pb-44 lg:pt-36 lg:pb-60 xl:pt-48 xl:pb-72\" style=\"background-image: url(https:\/\/carleton.ca\/news\/wp-content\/uploads\/sites\/162\/ontario-telehealth-cuts-fewer-trans-1200x900-1.jpg); background-position: 50% 50%;\">\n\n                    <div class=\"absolute top-0 w-full h-screen\" style=\"background-color:rgba(0,0,0,0.600);\"><\/div>\n        \n        <div class=\"relative z-[2] max-w-4xl w-full flex flex-col items-center gap-2 cu-wideimage-image cu-zero-first-last\">\n            <header class=\"mx-auto mb-6 text-center text-white cu-pageheader cu-component-updated cu-pageheader--center md:mb-12\">\n\n                                    <h1 class=\"cu-prose-first-last font-semibold mb-2 text-3xl md:text-4xl lg:text-5xl lg:leading-[3.5rem] cu-pageheader--center text-center mx-auto after:left-px\">\n                        Cuts to telehealth in Ontario mean fewer trans and non-binary people will have access to life-saving health care\n                    <\/h1>\n                \n                            <\/header>\n        <\/div>\n\n                    <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"absolute bottom-0 w-full z-[1]\" fill=\"none\" viewbox=\"0 0 1280 312\">\n                <path fill=\"#fff\" d=\"M26.412 315.608c-.602-.268-6.655-2.412-13.524-4.769a1943.84 1943.84 0 0 1-14.682-5.144l-2.276-.858v-5.358c0-4.876.086-5.358.773-5.09 1.674.643 21.38 5.84 34.646 9.109 14.682 3.59 28.935 6.858 45.936 10.449l9.874 2.089H57.322c-16.4 0-30.31-.16-30.91-.428ZM460.019 315.233c42.974-10.074 75.602-19.88 132.443-39.867 76.16-26.791 152.063-57.709 222.385-90.663 16.7-7.823 21.336-10.074 44.262-21.273 85.004-41.688 134.719-64.193 195.291-88.413 66.55-26.577 145.2-53.584 194.27-66.765C1258.5 5.626 1281.34 0 1282.24 0c.17 0 .34 27.596.34 61.3v61.299l-2.23.375c-84.7 13.718-165.93 35.955-310.736 84.931-46.494 15.753-65.427 22.076-96.166 32.15-9.102 3-24.814 8.198-34.989 11.574-107.543 35.954-153.008 50.422-196.626 62.639l-6.74 1.876-89.126-.054c-78.135-.054-88.782-.161-85.948-.857ZM729.628 312.875c33.229-10.985 69.248-23.523 127.506-44.207 118.705-42.223 164.596-57.709 217.446-73.302 2.62-.75 8.29-2.465 12.67-3.751 56.19-16.772 126.94-33.597 184.17-43.671 5.07-.91 9.66-1.768 10.22-1.875l.94-.161v170.236l-281.28-.054H719.968l9.66-3.215ZM246.864 313.411c-65.041-2.251-143.047-12.11-208.432-26.256-18.375-3.965-41.73-9.538-42.202-10.074-.171-.214-.257-21.38-.214-47.046l.129-46.618 6.654 3.697c57.313 32.043 118.491 56.531 197.699 79.143 40.313 11.521 83.459 18.058 138.669 21.059 15.584.857 65.685.857 81.14 0 33.744-1.876 61.306-4.93 88.396-9.806 6.396-1.126 11.634-1.983 11.722-1.929.255.375-20.48 7.769-30.999 11.038-28.592 8.948-59.288 15.646-91.873 20.147-26.36 3.59-50.015 5.627-78.35 6.698-15.584.59-55.209.59-72.339-.053Z\"><\/path>\n                <path fill=\"#fff\" d=\"M-3.066 295.067 32.06 304.1v9.033H-3.066v-18.066Z\"><\/path>\n            <\/svg>\n            <\/div>\n\n    \n\n    <\/div>\n<\/section>\n\n<p>This article is <a href=\"https:\/\/theconversation.com\/cuts-to-telehealth-in-ontario-mean-fewer-trans-and-non-binary-people-will-have-access-to-life-saving-health-care-198502\" rel=\"noopener noreferrer\" target=\"_blank\">republished<\/a> from The Conversation under a Creative Commons licence. All photos provided by <a href=\"https:\/\/theconversation.com\" rel=\"noopener noreferrer\" target=\"_blank\">The Conversation<\/a> from various sources.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><iframe loading=\"lazy\" style=\"width: 100%; height: 100px; border: none; position: relative; z-index: 1;\" height=\"400\" src=\"https:\/\/narrations.ad-auris.com\/widget\/the-conversation-canada\/cuts-to-telehealth-in-ontario-mean-fewer-trans-and-non-binary-people-will-have-access-to-life-saving-health-care\" width=\"100%\"><\/iframe><\/p>\n\n\n\n<p>Amid a <a href=\"https:\/\/www.ctvnews.ca\/health\/i-thought-i-might-die-at-home-canada-s-health-care-system-is-crumbling-experts-say-1.6036628\" target=\"_blank\" rel=\"noopener noreferrer\">crumbling<\/a> health-care system and <a href=\"https:\/\/www.cbc.ca\/news\/canada\/canada-us-transgender-hate-1.6503087\" target=\"_blank\" rel=\"noopener noreferrer\">rising transphobia<\/a>, trans and non-binary people in Ontario are facing a new challenge: reduced access to gender-affirming care. Changes to how the Ontario government funds virtual health-care services have led to the closure of a key resource, <a href=\"https:\/\/www.connect-clinic.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">the Connect-Clinic<\/a>.<\/p>\n\n\n\n<p>The clinic provides vital health-care services, and its closure means fewer trans and non-binary people will get the life-saving medical care they need. Gender-affirming care providers should be exempt from these rate cuts to maintain trans and non-binary people&#8217;s access to health-care services.<\/p>\n\n\n\n<h2 id=\"telehealth-essential-connect-clinic-closes\" class=\"wp-block-heading\">Telehealth essential: Connect-Clinic closes<\/h2>\n\n\n\n<p>The Connect-Clinic is a specialized virtual clinic that provides <a href=\"https:\/\/transcare.ucsf.edu\/guidelines\/overview\" target=\"_blank\" rel=\"noopener noreferrer\">gender-affirming care<\/a> to trans and non-binary people across Ontario. The clinic provides hormone therapy and surgery referrals that many trans and non-binary people describe as <a href=\"https:\/\/www.cbc.ca\/radio\/day6\/gender-affirming-care-1.6664121\" target=\"_blank\" rel=\"noopener noreferrer\">life-saving<\/a>. But the Connect-Clinic is now unable to provide virtual consultations because of recent changes to how doctors are paid for virtual appointments.<\/p>\n\n\n\n<p>When the COVID-19 pandemic began, doctors were paid the same amount for an appointment by video or phone call as they were for an in-person appointment. This allowed for <a href=\"https:\/\/doi.org\/10.1186\/s12875-022-01902-9\" target=\"_blank\" rel=\"noopener noreferrer\">greatly expanded access to virtual care<\/a> across Ontario.<\/p>\n\n\n\n<p>But <a href=\"https:\/\/www.health.gov.on.ca\/en\/pro\/programs\/ohip\/bulletins\/redux\/bul220901.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">as of Dec. 1, 2022,<\/a> the Connect-Clinic can only bill $20 for a video appointment and $15 for a phone appointment. Previously, <a href=\"https:\/\/torontolife.com\/city\/my-clinic-saves-lives-the-ford-governments-funding-cuts-to-virtual-health-care-will-shut-us-down\/\" target=\"_blank\" rel=\"noopener noreferrer\">the Connect-Clinic could receive $67 or more per appointment<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image align-center zoomable\"><a href=\"https:\/\/images.theconversation.com\/files\/507444\/original\/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\" target=\"_blank\" rel=\"noopener noreferrer\"><img decoding=\"async\" src=\"https:\/\/images.theconversation.com\/files\/507444\/original\/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" alt=\"A doctor speaking with a person on a laptop screen during a telehealth call.\"\/><\/a><figcaption class=\"wp-element-caption\"><span class=\"caption\">Reduced billing rates for telehealth appointments mean fewer trans and non-binary people will be able to access medical services.<\/span><br>\n<span class=\"attribution\"><span class=\"source\">(Shutterstock)<\/span><\/span><\/figcaption><\/figure>\n\n\n\n<p>The new reduced rates aren&#8217;t enough to cover the specialized care that the Connect-Clinic provides. As a result, the clinic has <a href=\"https:\/\/www.connect-clinic.com\/virtualhealthcare\" target=\"_blank\" rel=\"noopener noreferrer\">paused appointments<\/a> for their 1,500 patients and closed their waitlist of over 2,000 trans and non-binary individuals.<\/p>\n\n\n\n<h2 id=\"gender-affirming-care-saves-lives\" class=\"wp-block-heading\">Gender-affirming care saves lives<\/h2>\n\n\n\n<p>Gender-affirming care is essential to trans and non-binary people&#8217;s health and well-being. Research has consistently found that gender-affirming medical care significantly improves the <a href=\"https:\/\/doi.org\/10.1080\/19359705.2021.2016537\" target=\"_blank\" rel=\"noopener noreferrer\">mental health<\/a> and <a href=\"https:\/\/doi.org\/10.1210\/jendso\/bvab011\" target=\"_blank\" rel=\"noopener noreferrer\">quality of life<\/a> of trans and non-binary people.<\/p>\n\n\n\n<p>Based on a large survey of trans and non-binary people in Ontario, members of our <a href=\"https:\/\/transpulsecanada.ca\/\" target=\"_blank\" rel=\"noopener noreferrer\">Trans PULSE Canada<\/a> research team found that having access to all desired gender-affirming medical care <a href=\"https:\/\/doi.org\/10.1186\/s12889-015-1867-2\" target=\"_blank\" rel=\"noopener noreferrer\">reduced suicidal ideation by 62 per cent<\/a>.<\/p>\n\n\n\n<p>Unfortunately, accessing gender-affirming care is difficult in Ontario. Services are provided through a patchwork of community health centres, hospital-based clinics and individual family physicians. Many clinics are dealing with <a href=\"https:\/\/ottawacitizen.com\/opinion\/johnstone-time-to-act-on-gender-affirming-health-care-in-ontario\" target=\"_blank\" rel=\"noopener noreferrer\">long waitlists<\/a> and demand that far exceeds capacity. Our <a href=\"https:\/\/doi.org\/10.9778\/cmajo.20210061\" target=\"_blank\" rel=\"noopener noreferrer\">own research<\/a> found that one-third of trans and non-binary people who need gender-affirming medical care were on a waitlist.<\/p>\n\n\n\n<h2 id=\"the-importance-of-virtual-care\" class=\"wp-block-heading\">The importance of virtual care<\/h2>\n\n\n\n<p>Virtual care can help bridge this gap. In 2020, our research team surveyed 820 trans and non-binary people in Canada. <a href=\"https:\/\/doi.org\/10.2196\/40989\" target=\"_blank\" rel=\"noopener noreferrer\">We found that 33 per cent of participants<\/a> would prefer to access health care virtually rather than in-person once the COVID-19 pandemic was over.<\/p>\n\n\n\n<p>Participants living with anxiety or chronic health conditions were even more likely to prefer virtual care. Our participants emphasized the importance of flexibility in access to both in-person and virtual care.<\/p>\n\n\n\n<p>The Connect-Clinic has helped thousands of trans and non-binary people across Ontario access gender-affirming care through virtual appointments. Their services are especially important for people living in rural and remote areas who do not have any gender-affirming care providers in their area.<\/p>\n\n\n\n<p>The closure of the Connect-Clinic has added even more stress to a health-care system facing already <a href=\"https:\/\/www.cihi.ca\/en\/news\/ongoing-pandemic-driven-pressures-impact-activities-and-workload-of-health-care-workers-across\" target=\"_blank\" rel=\"noopener noreferrer\">severe worker shortages<\/a> and <a href=\"https:\/\/globalnews.ca\/news\/9329715\/ontario-long-waiters-pandemic-surgery\/\" target=\"_blank\" rel=\"noopener noreferrer\">long wait times<\/a>. Trans and non-binary people will suffer as a result.<\/p>\n\n\n\n<figure class=\"wp-block-image align-center\"><img decoding=\"async\" src=\"https:\/\/images.theconversation.com\/files\/507192\/original\/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" alt=\"A man in a dark suit speaking at a podium with a sign that reads: Your heath, Votre sante.\"\/><figcaption class=\"wp-element-caption\"><span class=\"caption\">Ontario Premier Doug Ford makes an announcement on health care in the province with Health Minister Sylvia Jones in Toronto on Jan. 16, 2023.<\/span><br>\n<span class=\"attribution\"><span class=\"source\">THE CANADIAN PRESS\/Frank Gunn<\/span><\/span><\/figcaption><\/figure>\n\n\n\n<h2 id=\"telehealth-compounding-barriers-to-access\" class=\"wp-block-heading\">Telehealth: Compounding barriers to access<\/h2>\n\n\n\n<p>Even before the closure of the Connect-Clinic, trans and non-binary people in Ontario had a much harder time accessing health care than their cisgender (non-trans) peers.<\/p>\n\n\n\n<p>While all primary care providers are able to prescribe hormone therapy and refer patients to surgeons, gender-affirming care is <a href=\"https:\/\/doi.org\/10.1089\/trgh.2016.0010\" target=\"_blank\" rel=\"noopener noreferrer\">rarely covered in medical education<\/a>, and many family doctors <a href=\"https:\/\/doi.org\/10.1186\/1472-6963-12-110\" target=\"_blank\" rel=\"noopener noreferrer\">do not feel confident or experienced enough<\/a> to provide gender-affirming care. As a result, many trans and non-binary people turn to specialized clinics, such as the Connect-Clinic.<\/p>\n\n\n\n<p>In 2019, we surveyed nearly 3,000 trans and non-binary people from across Canada. <a href=\"https:\/\/doi.org\/10.9778\/cmajo.20210061\" target=\"_blank\" rel=\"noopener noreferrer\">We found that only 55 per cent of participants<\/a> from Ontario had a primary care provider with whom they were comfortable discussing their gender. Furthermore, 42 per cent of Ontario participants had at least one unmet health care need in the past year.<\/p>\n\n\n\n<p>In comparison, <a href=\"https:\/\/doi.org\/10.25318\/1310083601-eng\" target=\"_blank\" rel=\"noopener noreferrer\">less than seven per cent of the general population<\/a> said the same in 2019. The closure of the Connect-Clinic is likely to make accessing health care even harder for trans and non-binary people.<\/p>\n\n\n\n<h2 id=\"the-need-for-an-exemption-to-rate-cuts\" class=\"wp-block-heading\">The need for an exemption to rate cuts<\/h2>\n\n\n\n<p>Other medical providers, such as those providing <a href=\"https:\/\/globalnews.ca\/news\/9180526\/addiction-doctors-ontario-government-deal-virtual-care\/\" target=\"_blank\" rel=\"noopener noreferrer\">addiction medicine<\/a>, were given an exemption from the physician services agreement. That exemption allows them to continue to be paid the same amount for virtual and in-person appointments.<\/p>\n\n\n\n<p>Considering the unique needs of trans and non-binary patients, gender-affirming care must be provided the same exemption. Addiction medicine and gender-affirming care both require specialized expertise and non-stigmatizing providers that are not always available to patients locally.<\/p>\n\n\n\n<p>Maintaining the previous billing rates for virtual visits is essential to enable the Connect-Clinic and other clinics to continue providing vital gender-affirming care for trans and non-binary people in Ontario.<\/p>\n\n\n\n<p>&#8212;<br>\n<a href=\"https:\/\/newsroom.carleton.ca\">Carleton Newsroom<\/a><\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/counter.theconversation.com\/content\/198502\/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\"\/><\/figure>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This article is republished from The Conversation under a Creative Commons licence. All photos provided by The Conversation from various sources. Amid a crumbling health-care system and rising transphobia, trans and non-binary people in Ontario are facing a new challenge: reduced access to gender-affirming care. Changes to how the Ontario government funds virtual health-care services [&hellip;]<\/p>\n","protected":false},"author":410,"featured_media":86280,"template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"cu_story_type":[1623],"cu_story_tag":[],"class_list":["post-86278","cu_story","type-cu_story","status-publish","has-post-thumbnail","hentry","cu_story_type-expert-perspectives"],"acf":{"cu_post_thumbnail":false},"_links":{"self":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story\/86278","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story"}],"about":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/types\/cu_story"}],"author":[{"embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/users\/410"}],"version-history":[{"count":3,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story\/86278\/revisions"}],"predecessor-version":[{"id":86283,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story\/86278\/revisions\/86283"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/media\/86280"}],"wp:attachment":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/media?parent=86278"}],"wp:term":[{"taxonomy":"cu_story_type","embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story_type?post=86278"},{"taxonomy":"cu_story_tag","embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story_tag?post=86278"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}