Researcher Background
Dr. Alex Abramovich is a Senior Scientist at the Institute for Mental Health Policy Research at the Centre for Addiction and Mental Health (CAMH), and an Associate Professor at the Dalla Lana School of Public Health at the University of Toronto. Dr. Abramovich holds a Canada Research Chair in 2SLGBTQ+ Youth Homelessness and Mental Health. He has been addressing the issue of 2SLGBTQ+ youth homelessness for over 15 years. Dr. Abramovich is an award winning and internationally recognized leader in 2SLGBTQ+ health and homelessness. The overarching aim of his program of research is to investigate the health and social inequities experienced by 2SLGBTQ+ individuals, with a focus on understanding and improving the health and service needs of 2SLGBTQ+ youth and young adults. Dr. Abramovich’s research has led to groundbreaking practice and policy reform, including the launch of Canada’s first dedicated transitional housing program for 2SLGBTQ+ youth. He has worked closely with all levels of government to develop policies and strategies that address the needs of 2SLGBTQ+ youth and young adults experiencing homelessness and is committed to research that successfully and ethically engages marginalized populations.
Purpose of this Research Project
Background: Transgender adolescents and youth experience a disproportionately high burden of mental and physical health challenges, alongside significant barriers to accessing healthcare. Despite this, population-level evidence on their health outcomes and healthcare utilization in Canada remains limited, largely due to the absence of gender identity data in administrative health systems.
Objectives: This study aims to (1) Describe the demographic and clinical characteristics of a large cohort (N=2,500) of transgender youth in Ontario, (2) Examine the healthcare utilization patterns among transgender youth, including subgroup differences, compared to the general population, (3) Explore the healthcare experiences and needs among transgender youth through lived experience perspectives, and (4) Generate evidence-based recommendations to improve care.
Methods: We will use a mixed-methods sequential explanatory design. In Phase 1, we will assemble a retrospective cohort of approximately 2,500 transgender adolescents and youth (ages 12–24) by linking primary data from gender care clinics to Ontario’s population-based administrative health data held at ICES (2015–2021). Outcomes include physical and mental health conditions, and healthcare utilization across primary care, specialist services, emergency department visits, and hospitalizations. A matched general population cohort will be used for comparison. In Phase 2, we will conduct in-depth semi-structured interviews with approximately 45 transgender youth across developmental stages to contextualize and expand upon quantitative findings. Data will be integrated through triangulation to enhance interpretation and validity.
Results: This study will generate the first population-based evidence in Canada on health outcomes and healthcare utilization among transgender youth, while identifying subgroup differences and key drivers of healthcare access.
Conclusions: Findings will address critical gaps in transgender health research and inform policies, programs, and clinical practices aimed at improving equitable, accessible, and youth-centered care for transgender populations.
How this Research Will Help 2SLGBTQ+ People and Communities
This study will provide an in-depth understanding of the health outcomes, disparities, and needs, as well as health service use patterns among trans adolescents and youth. This study has the potential to advance research focused on trans and gender-diverse populations, and make significant contributions in the areas of public health, mental health, and medical education. The knowledge generated can inform clinical decision making and interventions for trans youth, inform the psychoeducation offered to families and training delivered to health professionals, and advocate for trans inclusive and affirming practice and policy change. Findings will be translated into medical education, academic papers, conference presentations, media articles, infographics, and a technical report. This project has the potential to transform existing services for adolescents and youth and provide evidence-informed recommendations for new and improved medical and social services for trans youth. Findings will be used to make recommendations for the development of affirming and inclusive health services and/or interventions that support trans youth to grow and develop into healthy adults.
Eligibility & Participation
The criteria for eligible participants include: self-identify as transgender; 12-24 years old; live in Ontario; have accessed health services at one of the participating clinics (Centre for Addiction and Mental Health (CAMH), Gender Identity Clinic; SickKids, Transgender Youth Clinic; and Children’s Hospital of Eastern Ontario (CHEO), Gender Diversity Clinic in the past six years (since 2020), and have the capacity to consent.
Compensation
Participants will receive a $40 gift card of their choosing for their participation.
Participant Support & Mitigation Measures
If a participant is experiencing significant emotional distress or suicidality, the interview will be discontinued and a safety protocol will be followed to support the participant.
How to Participate / Recruitment
Participants are being recruited using recruitment posters, which have been shared at health clinics, including Centre for Addiction and Mental Health (CAMH), Gender Identity Clinic, SickKids, Transgender Youth Clinic, and Children’s Hospital of Eastern Ontario (CHEO), Gender Diversity Clinic.