A gender-affirming care clinic in Thunder Bay, Ontario, is closing, leaving patients with limited options

One of the only clinics offering gender-affirming medical care in Thunder Bay, Ontario, has closed, leaving transgender patients in the city and surrounding area with few options.

Last week, the Umbrella Medical Clinic Which provides sexual health servicesIt was announced that it will be closed until further notice.

“It feels like whiplash,” Dax O’Neil, a patient, said of the Umbrella Clinic’s closing. “It will be difficult for me to get the testosterone treatment I need.”

Gender affirming care is an umbrella term for health care that supports a patient’s gender identity and expression. It can include any combination of counselling, hormone therapy, puberty blockers and surgery.

A medical clinic has a closed sign on its door
The Umbrella Medical Clinic, which provides gender-affirming medical care in Thunder Bay, Ontario, has announced that it will close its doors effective January 29. (Mark Doucet/CBC)

The Umbrella Medical Clinic opened in 2018 with the goal of filling gaps in Thunder Bay’s healthcare system by offering everything from transgender healthcare to emergency contraception and HIV prevention. It closed temporarily in October 2021 after its founder, Dr. Annabella Zawada, unexpectedly passed away, but reopened in August 2022.

O’Neill has not received any information about whether Umbrella Medical will reopen or refer to other practitioners.

The director of Umbrella Medical declined to be interviewed by CBC News, but said in an email that he should monitor his website for updates.

Many patients in transition use testosterone to reduce estrogen production and stimulate “masculine” physical traits. Because it’s a federally controlled substance, many outpatient clinics won’t prescribe it, and O’Neill said he relies on specialists or family doctors for replenishments.

O’Neill added that he wishes the Umbrella Clinic would tell if the closure is permanent or provide more information.

“They didn’t mention any resources we could turn to or even try to connect us with anything. It was like, ‘Fend for yourself,'” O’Neill said. “I feel like I’ve been abandoned.”

NorWest Community Health Centers in Thunder Bay also provides “gender affirming shared care,” according to its website.

But Sarah Martin, another Umbrella Medical patient, also found herself scrambling to find resources.

Not being able to access this care can be a matter of life or death.– Dr. François Doiron

“I’m very upset. I felt like part of the herd at Umbrella,” she said. “I know the people there really care about all of us.”

Martin, who has been undergoing hormone replacement therapy (HRT) for more than two years, said all she needs to do is renew her prescriptions and have annual checkups to monitor any side effects that could occur. But Martin said she’s concerned it will be difficult to find a provider comfortable enough to handle HRT in Thunder Bay.

Dr. Francois Doiron, a family physician in Dryden who provides gender-affirming care to patients in the area, said Martin’s concerns are justified, and this care is crucial to them.

“Not being able to access this care can be a matter of life and death,” Doiron said.

“This population is at high risk for depression and poor mental health outcomes,” he said. Suddenly stopping certain types of gender-affirming care, such as hormone therapy, can have significant negative effects on physical health.

Fresh air11:31“The biggest risk is not helping them”; Why a Dryden doctor urges more family doctors to offer gender confirmation care

Dr. Francois Doiron, a family physician in Dryden, talks about the importance of offering gender-affirming care to patients across the province and why he hopes more family doctors will offer it to patients in their offices.

How family doctors can play a role

Both O’Neill and Martin said family doctors have previously expressed discomfort with providing gender-affirming care.

Few doctors in Ontario offer such services. It’s difficult to find a provider, even in big cities like Toronto, and it’s even more difficult in northwestern Ontario, Doiron said.

“It’s beyond difficult,” he said. “Sometimes it’s almost impossible.”

A 2019 Trans Pulse Canada survey of trans and non-binary people aged 14 and over from across Canada found Nearly 45 percent of them reported that their health care needs were not met. Among survey participants who were continuing their gender-affirming care, 40 percent reported that they were on waiting lists, most often for surgery.

Both O’Neill and Martin said they want to see more practitioners in Thunder Bay providing gender-affirming care.

“I hope our GPs and family doctors can get more involved in this as it becomes more prevalent in the community,” Martin said. “Our care is really not that difficult to deal with.”

O’Neill wants to open another clinic in Thunder Bay with community support.

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