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Accessing gender-affirming care proves difficult for Kelowna transgender man

Being transgender comes with its fair share of challenges including discrimination, body dysphoria, mental health issues, access to proper healthcare, the list goes on. When it comes to being transgender in Kelowna, these challenges can be exacerbated.

John Kingston is a 20-year-old transgender man who lives in Kelowna, and he's struggled his whole life with being accepted for who he is. He believes that living in a more conservative and smaller city has affected the care he can access.

"I knew I was trans since I was very, very little - I remember when I was three years old, my grandmother was telling me ‘You’re a girl because you were born with this body’ and even then, in my little mind, I knew I was not a girl," Kingston says.

"Being different in my gender identity was not an option I was taught existed my whole childhood."

Kingston arrived in Canada from Ukraine at the age of seven with his mother and grandmother. While he says the move to Canada softened his mother up, he still greatly struggled with being accepted in his own family.

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"My family was not very accepting - I remember being forced to wear dresses, having feminine toys be bought for me, being taught to be feminine because 'I’m a girl and that’s how girls are supposed to be,'" Kingston says.

"The first time I heard about transgender people, my grandmother and I were watching TV, and the topic came up. The first thing I heard out of my grandmother's mouth was 'these people are mentally ill and mutilating themselves, don’t be like them.'"

When Kingston went to school, he had to face more discrimination and cruelty. While his friends accepted a version of him, narratives of hate persisted.

"At school, I hung out with mostly boys, who accepted me as a tomboy, but a lot of other kids bullied me for not conforming to feminine gender roles. Even in the group that accepted me, it was considered shameful to be gay or trans and all the children would mock LGBT people all the time."

Kingston then went on to learn more about sexual orientation and gender identity in sex education. 

"The only positive representation of LGBT people I got as a younger child, was when my school did sex ed classes," he says.

"They made sure to be LGBT inclusive and discussed gender identity and whatnot, and that was one of the only times that I remember even thinking it was OK to be different like that."

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Kingston waited until he had reached the age of majority to come out to his friends and family. He felt he had to repress his identity until then because of the unaccepting environment he was surrounded by at home and outside of home.

The community that surrounded him never felt accepting enough, and he feels that deeply affected him and, to this day, he still feels the consequences of that.

"I don’t feel like I’ve had a strong community to support me: my peers at school weren’t accepting, my family wasn’t either, and I feel that has had an impact on my ability to socialize properly," he says.

"A lot of the journey I took in accepting myself, I had to take on my own, without many accepting people by my side. That is why it took me until I was considered a legal adult to come out. "

Now that he's out and an adult, Kingston has started taking steps to transition, but being in a smaller city like Kelowna has affected the availability of the care he can access.

The first step in his process is to start hormone replacement therapy, but this care is not readily available to him.

"My GP referred me to an endocrinologist, but I could wait up to six months before even seeing one. Even then, my doctor told me most endocrinologists require a hormone therapy readiness assessment from a mental health professional which is usually expensive and not exactly time-saving," Kingston says.

"Because of that, I don’t plan on relying on an endocrinologist to get my HRT due to the challenges of long wait times, while having severe gender dysphoria, and the cost of a mental health assessment."

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An alternative for Kingston would be to find a general practitioner who has enough knowledge of hormone replacement therapy and would rely on informed consent to prescribe and administer the hormones in person.

In Kelowna, these types of medical professionals are hard to find.

"I tried getting into contact with one of the few sexual health clinics here in Kelowna, as I heard they do gender-affirming care relatively fast compared to endocrinologists, but I am not homeless and I have a family doctor, so they told me they could not work with me as they only serve those who meet those criteria," Kingston says.

Kingston has now reached out to Trans Care BC to find out about other ways to access gender-affirming care that will not require expensive mental health assessments and will not take too long as dealing with gender dysphoria for much longer is not sustainable for his mental health and wellbeing.

He still awaits answers as it can take up to 14 business days to hear back.

Kingston feels like he knows what type of care would be best for him, but is frustrated by the fact that he can't access that care, and might just have to settle for whatever is available in the region at the cost of his wellbeing.

"I definitely feel that the process of transitioning would be easier if I were living in Vancouver or a bigger liberal city," he says.

"There would most likely be far more GPs who would be qualified to do in-person readiness assessments and prescribe HRT, which would be convenient for saving money, and getting better treatment with more experienced people, possibly even faster wait times."

To learn more about gender-affirming care and resources available in the province, visit the Trans Care BC website here


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