Having any other mental health diagnosis (for example: depression, anxiety, mood disorders) does not automatically hurt your access to gender affirming care. Similarly, other “intellectual disabilities” or neurodivergent conditions (for example: being on the autism spectrum) cannot be used as a reason to deny someone care. The Ontario Human Rights Code is very clear that the presence of any of these conditions does not reduce your capacity to consent to treatment. This means that a doctor is not allowed to tell you that, for example, you are not allowed to start on hormones solely because you have a diagnosis of depression. If you have the capacity to consent, you are allowed to make decisions for your body and your health, even if it is a decision that other adults may not agree with.

However, if your doctor believes you are a danger to yourself or to other people around you, they may restrict your access to care. If you are experiencing severe suicidal ideation (i. e. if you are frequently thinking about hurting yourself, or have a plan to hurt or kill yourself) this can be a reason for a doctor to restrict your access to hormones. If you are having a serious crisis, have poorly controlled psychosis, or are severely intoxicated (i. e. drunk or high), a doctor will want to help you with these issues before you can have a discussion about hormones or other transition care. Every situation is different, and you and your doctor will work together to figure out what is best for you.

The Trans PULSE study showed that suicidal ideation can be significantly reduced by access to transition-related treatments. If you are experiencing suicidal thoughts because of your gender dysphoria, it may be appropriate for a doctor to start you with hormones while also addressing your other symptoms. It’s best to talk to your doctor or other health care provider about your specific situation.

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