Why is trans care urgent?

Suicide ideation and attempt rates are alarmingly high among trans people.

A recent 2010 TransPulse survey of 433 trans people in Ontario aged 16 and older found extremely high rates of suicidal ideation and attempt.

  • Bauer GR, Pyne J, Francino MC, Hammond R. La suicidabilité parmi les personnes trans en Ontario: implications en travail social et en justice sociale. Service social. 2013; 59(1): 35–62. doi: 10.7202/1017478ar
  • Scanlon K, Travers R, Coleman T, Bauer G, Boyce M: Ontario’s trans communities and suicide: transphobia is bad for our health. Trans PULSE e-Bulletin. 2010, 1 (2): 1-2.
  • Weissman, M. M. et al. (1999). Prevalence of suicide ideation and suicide attempts in nine countries. Psychological Medicine, 29(1), 9–17.

Compare rates between trans and cis people:

Why is access to medical transition care important?

Professional transition support for those who need it can profoundly improve the well-being of trans people.

Many trans people will seek medical assistance in order bring their physical appearance in line with their gender identity. This could include hormone therapy and/or surgery.

Researchers have identified that completing a medical transition for those who need it could substantially increase a person’s well-being. Most at risk for considering/attempting suicide were people who were planning but had not begun a medical transition.

* In this study completed transition was based on participant self-report and may involve any combination of hormones or surgery/surgeries

Suicidal ideation and attempt rates of trans people at different stages of medical transition:

  • Bauer GR, Scheim AI, for the Trans PULSE Project Team (2015). Transgender People in Ontario, Canada: Statistics to Inform Human Rights Policy.
  • Bauer, G., K, A., Pyne, J., Scanlon, K., & Travers, R. (2012). Improving the health of trans communities: Findings from the Trans Pulse Project. Conference presentation presented at the Rainbow Health Ontario Conference, Ottawa, ON.

What are barriers to care?

Accessing care services

It remains a frequent challenge for trans people to access health care services for general and transition-related services.

Negative experiences & mistreatment

Many have had negative experiences including discomfort, denial and discrimination. Click the plus button to view examples.

See more research on negative experiences of trans clients

were not comfortable discussing trans issues with their doctor.


perceived their physician to be not at all knowledgable about trans health issues.


have been denied hormone prescriptions.


avoided emergency room care because they perceived their trans status would negatively affect the encounter.



obtained hormones from nonmedical sources.






  • Bauer GR, Zong X, Scheim AI, Hammond R, Thind A (2015)
  • Rotondi, N. K., Bauer, G. R., Scanlon, K., Kaay, M., Travers, R., & Travers, A. (2013).
  • Bauer GR, Scheim AI, Deutsch MB, Massarella C. (2013)

What is the role of primary care?

Facilitating access to competent primary care could substantially reduce suicidal distress. A TransPULSE study of 380 trans people in Ontario revealed that among individuals who desired medical transition, those on hormone therapy were about half as likely to have suicidal thoughts.

Learn about the various medical and non-medical health care needs of trans clients
  • Bauer GR, Scheim AI, for the Trans PULSE Project Team (2015). Transgender People in Ontario, Canada: Statistics to Inform Human Rights Policy.
  • Bauer GR, Scheim AI, Pyne J, Travers R, Hammond R. Intervenable factors associated with suicide risk in transgender persons: a respondent-­‐driven sampling study in Ontario, Canada. BMC Public Health 2015; 15: 525.

What are common fears around providing hormone therapy?

Primary health care needs