A dreamy image shows a young queer person shirtless from behind, with digital glitch effects and scribbles representing the disorientation of gender dysphoria.

“We have to be prepared for the clients we’re providing care to”: 2SLGBTQ+ Healthcare in Perth-Huron

 in United Insights  tagged 2SLGBTQ Discrimination and Integration / Access to Services

2SLGBTQ+ locals report having to educate their doctors

A dreamy image shows a young queer person shirtless from behind, with digital glitch effects and scribbles representing the disorientation of gender dysphoria.

Put Your Back Into It by Baz Kanold. Kanold is a Waterloo-region artist whose work was recently exhibited at the Exeter library.

This is a post by Daniel Layden, a PhD student in Rural Studies at the University of Guelph, and Leith Deacon, an Associate Professor in the School of Environmental Design and Rural Development at the University of Guelph.

“I just needed them to be ready to meet me at step one.”

This reflection comes from a new study on 2SLGBTQ+ experiences in Perth and Huron Counties. It speaks to a critical dimension of healthcare access: feeling seen, respected, and understood from the very beginning of care.

Healthcare access is about more than the availability of services. For 2SLGBTQ+ residents in Perth and Huron Counties, access is also shaped by whether healthcare environments are informed, inclusive, and affirming. Participants in the study described navigating physician shortages alongside additional barriers, including providers with limited knowledge of 2SLGBTQ+ health needs, uncertainty about whether care would be respectful, and the need to travel outside the region to find appropriate support.

Strengthening healthcare access means investing not only in more services, but also in provider education, inclusive policies and practices, and models of care grounded in dignity, humility, and respect. 

Perth and Huron Counties face many of the same healthcare challenges seen across Southern Ontario, including physician shortages and difficulty accessing a regular family doctor. However, for 2SLGBTQ+ residents, these challenges can be compounded by additional barriers within healthcare systems that are not always designed to be inclusive and affirming.

This post focuses on one part of a study conducted by the University of Guelph’s School of Environmental Design and Rural Development and the United Way Perth-Huron Social Research and Planning Council. The study, conducted in 2025, asked 2SLGBTQ+ people in Perth and Huron Counties about their experiences with local services. This blog post discusses the experiences of 11 participants who were interviewed as part of the research and spoke about healthcare services.

“Services that were not prepared to accept a client like me”

For almost all of these participants, the issue was not simply whether healthcare services existed, but whether those services were knowledgeable and equipped to support 2SLGBTQ+ patients. As one gender minority participant explained:

“If I’m not going to a specific clear service that actually serves trans people and is educated on it, I’ll be running into stuff that has not been made for me. I’ll be running into services that were not prepared to accept a client like me.” — Participant 2

This comment reflects a broader concern shared by participants: healthcare access is shaped not only by geography or service availability, but also by whether providers and systems are equipped to offer appropriate care. Four participants described travelling outside the region, including to Toronto, in order to access doctors or services with specific knowledge of gender-affirming care. While supportive local services were identified, such as the Stratford Sexual Health Clinic, three participants still described healthcare encounters where they were required to educate providers themselves.

These concerns were especially pronounced among 2SLGBTQ+ participants who were gender minorities, including transgender and non-binary individuals. The broader study found that gender minority participants reported higher levels of direct discrimination (64.2%) than cisgender 2SLGBTQ+ participants (45.7%). While sexual minority participants also described discrimination and discomfort in healthcare settings, gender minority participants often faced additional challenges finding practitioners who were knowledgeable, affirming, and confident in supporting their healthcare needs.

For some participants, a provider’s willingness to learn made a significant difference. One participant noted:

“I feel more confident in that, when they’re willing to admit they don’t know something, but are prepared to learn it. That speaks volumes of confidence to me.” — Participant 2

This distinction was important. Participants did not necessarily expect every provider to have extensive expertise in 2SLGBTQ+ health. Rather, they wanted providers to approach care with respect and a willingness to learn. The same participant explained:

“I don’t need them to be on the level of understanding of transness that I have come to over a lifetime of building up this experience. I just needed them to be ready to meet me at step one, you know?” — Participant 2

The more serious concern was when providers were unwilling to learn, or expressed discriminatory assumptions. One participant described how a discriminatory medical encounter contributed to a broader distrust of healthcare:

“It also led to me having a real distrust of the medical field when the doctor… outright said to me. Oh, you’re gay. You probably have aids.” — Participant 13

“I’m not confident that I would get the healthcare I need in Huron-Perth”

Experiences such as these show how discrimination and lack of provider knowledge can create barriers beyond the general challenges of accessing care in rural regions. Participants were not only navigating physician shortages or limited local services, but they were also managing uncertainty of whether a provider would be affirming or knowledgeable about their health needs. Five participants described having to search extensively for a provider who would treat them appropriately. One participant, for example, had to go to three different doctors before finding one that would treat them. Another participant described accessing healthcare in Toronto, because they were not confident they could receive the care they needed locally:

“I’m not confident that I would get the healthcare I need in Huron-Perth, it’s definitely an issue.” — Participant 7

These experiences point to a broader issue in the health system: when providers lack knowledge of 2SLGBTQ+ health, patients may be referred elsewhere even when aspects of their care could be provided locally with appropriate training and support. This can place additional burdens on patients, including travel, time, cost, and the emotional labour of repeatedly seeking affirming care.

Participants also emphasized that healthcare challenges were not always caused directly by their 2SLGBTQ+ identity, as general concerns regarding shortage of services existed. For example, physician shortages and difficulty accessing a family doctor affect many residents across the region. However, almost all participants described experiences in which these broader challenges could be, or were, intensified by stigma, discrimination, or a lack of provider knowledge once they did access care.

“I had to bring the information to them”

Family doctors and general practitioners were often described as lacking knowledge about sexual and gender minority health. One participant described their doctor as a decent provider who was not overtly homophobic, but who still lacked the knowledge needed to support their care directly:

“I don’t necessarily recommend them as a doctor because like, yeah, they were fine and they weren’t homophobic and they offered me treatment, but I had to bring the information to them like they didn’t have any idea how to access that care.” — Participant 10

For participants, affirming care did not necessarily require every provider to be a specialist. Rather, it required a baseline of knowledge, respect, and a willingness to keep learning. One participant compared gender-affirming care to other areas of primary care:

“Managing diabetes is complicated, but we expect every GP in the country to be able to manage diabetes…[gender affirming care is] not medical rocket science, any GP should be able to do it. You don’t have to refer to an endocrinologist, but a lot of them do.” — Participant 7

This participant, who also has experience working in healthcare, continued by emphasizing the importance of ongoing practitioner education:

“I think because you didn’t do it in medical school is no longer good enough. I think you learn it.” — Participant 7

These findings are not only about individual provider behaviour. They also point to the need for systems, training, and clinic environments that better support 2SLGBTQ+ patients. Participants identified several practical changes that could make healthcare settings more welcoming, including asking for chosen names and pronouns, using inclusive intake forms, and ensuring gender options are not limited to only “female” and “male.” As one participant explained, even administrative details can shape whether a healthcare setting feels welcoming:

“The form may seem a trivial bureaucratic thing, but it can really set the tone in terms of welcoming experience.” — Participant 7

Overall, participants’ experiences show that improving healthcare access for 2SLGBTQ+ people in Perth and Huron Counties requires more than addressing physician shortages alone. It also requires healthcare environments that are informed, respectful, and equipped to meet the needs of 2SLGBTQ+ patients. Provider education, inclusive administrative practices, and care grounded in dignity, humility, and respect are all important parts of building a more accessible and affirming healthcare system. Because true access means more than opening clinic doors — it means ensuring people feel safe and supported when they walk through them.

For more information on this research and our community recommendations, read the full report: Discrimination and Community Integration Experienced by 2SLGBTQ+ in Perth-Huron.

June is Pride Month! Pride Month is an important time when 2SLGBTQ+ community members and allies gather in solidarity to support and celebrate the 2SLGBTQ+ community. Regional Pride events include:

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