Trans youth, transgender youth,
Youth whose gender hath trans.
We're all anyone can talk about nowadays.
Trans youth are coming up on TVA,
CBC, CTV, and... why, yes, I am Canadian, thank you for noticing.
The people leading the trans youth conversation
aren't trans youth themselves, though.
And they aren't advocates or specialists either.
But they claim to know what's best for us.
There's been an uptick in legislators and media personalities
saying it should be harder for trans youth to get hormones
or surgeries because we might live to regret it.
The conversation has been guided above all by fear.
And unfortunately, the voices of young trans people,
the ones actually affected by all this, have mostly gone unheard.
That's why at the start of this year, I joined forces with Trans PULSE Canada,
a community research project that conducted a big nationwide survey in 2019.
They asked almost 3,000 trans people across Canada
about their lives and the problems they ran into.
I think I was one of them,
but 2019 was like 40 years ago, so who knows?
The research team shared a ton of data with me,
so I could put together this 3-part series on trans youth and healthcare.
It's a controversial issue that really doesn't need to be.
We'll look at the healthcare trans youth want, how that care affects our lives,
how the healthcare system can better serve us.
I'm hoping I can clarify the facts and help allay all this moral panic going on.
The exact percentages and details of the findings may be unique to Canada,
so I'm not going to generalize anything to anywhere else
but if you know anything about this subject, a lot will sound familiar.
We tend to run into the same problems to varying degrees all over the place.
The first episode of the series is this! Welcome.
Episode 1 covers the basics of young people and medical transitions.
Before Trans PULSE, no one had done a survey like this in Canada.
Today, we've got pretty juicy findings
that have never been shared with the public before.
Is that exciting for other people? It is to me but I'm a stats nerd.
I used to read the Census for fun.
High school was rough.
LILY ALEXANDRE ET TRANS PULSE CANADA PRÉSENTENT
LES JEUNES TRANS CONTRE LE SYSTÈME DE SANTÉ
TITRE DE L'ÉPISODE (???????????????????????????????????????)
When we talk about trans youth, we tend to have a pretty specific image in mind.
A young, middle-class, white person assigned female at birth
who's feeling weird about starting puberty
and wants to remedy that with hormones and top surgery.
This image plays to old-school, cultural anxieties.
It triggers this feeling that gender- affirming care is endangering young girls.
and that making it easier to transition might hurt young people in the long run.
It's no wonder the anti-trans movement has run with this image,
but unsurprisingly, it does not represent most of us.
If we're going to dispel this idea that transition is hurting young people,
we should start by clarifying our image.
Who are trans youth? And what do we want?
For our purposes, trans youth are people between the ages of 14 and 24,
basically Gen Z, whose gender is different from the one assigned to them at birth.
I'm saying "trans" youth for the sake of brevity,
but not all of them identify specifically as trans.
They might use the word "nonbinary", or a word specific to their culture.
Out of the 3,000 people who answered the survey in 2019,
about 1,000 were youth.
That's a pretty solid sample size, but as we get into this,
keep in mind that it's not perfectly representative of everyone in 2022.
It's the best we've got but it's not perfect.
People might answer a little differently today.
And chances are, some groups answered more, and some, less.
Almost half the youth lived in Ontario,
even though Ontario has less than 40% of Canada's population.
Does that mean a kid born in Ontario is more likely to be trans?
"Are they putting chemicals in the water to turn the freakin' frogs trans?"
I'm thinking no.
With this out of the way, of the youth who've filled out the survey,
52% identified as nonbinary, or similarly as genderqueer,
34% identified as trans boys or men,
12% as identify as girls or women,
and 2% identified with a culturally specific gender.
Right out of the gate, these numbers are very different for younger people.
Compared to trans folks over 25,
youth are more likely to identify as nonbinary or trans men,
and way less likely to be trans women.
I've noticed this in community spaces too,
looking around, wondering "where all the girls at?"
The "girls" in question have our own little pet theories
why this might be, chiefly that being one of us
is notoriously frowned upon, so we might wait longer to come out.
That's not the only generational difference that came up.
Younger respondents are less likely to be straight,
with I kind of can't believe this,
only 5% identifying that way.
Compared to 9% of those over 25.
Kids are alright, baby!
They're also more likely to be Indigenous in Canada
and less likely to be immigrants.
When talking about trans healthcare, it's important to talk about young people
because not only are we demographically different, we also have different needs.
Younger trans people find themselves in a timeframe where puberty blockers
can be especially helpful.
In the survey, 14% of people between the ages of 14 and 17,
were currently taking puberty blockers.
About 1/3 of those who weren't said they wanted to be.
Puberty blockers prevent a person's secondary sex traits
from developing any further. They can help keep dysphoria
from getting worse while people explore their options
or wait until they're "old enough" for other treatments.
That's another difference between older and younger trans people.
If you're a minor, doctors tend to treat you more conservatively.
People are considered minors until they turn 18 or 19 depending on the province.
The World Professional Association for Transgender Health, or WPATH,
advises against gender-affirming surgeries for minors,
with the exception of transmasculine top surgery.
WPATH is pretty divisive in the trans community,
thanks to their position as gatekeepers.
I'm putting that lightly because this is not the place to go off.
In Canada, surgeons follow their standards of care
and rarely operate on minors.
All this frenzy about trans teenagers getting a bunch of surgeries
and irreversibly damaging their bodies...
it's at the very least overblown.
Actually, of all the survey respondents under 18,
only one got any kind of gender-affirming surgery.
It was a breast reduction, which cis girls under 18 get all the time.
Another reason I think we should talk about trans youth is...
being young is hard, you know.
Young people are vulnerable in general.
They struggle to fit in and manage their emotions,
they rely on the people around them for guidance and support.
Sometimes, those people let them down.
Many trans youth struggle with food and housing insecurity.
Most say they deal with bullying and harassment.
It's probably not a coincidence that we report worst mental health
in both young cis people and trans adults.
ANOTHER TITLE CARD (??????????????????????????????????????????????)
Let's talk some more about our needs.
Even though transition options are limited for people under 18,
most of the youth who filled out the survey
either wanted to medically transition or already had.
For those assigned male at birth, 57% were currently taking estrogen
and of those who weren't, about two thirds wanted to start.
For those assigned female at birth, 40% were taking testosterone
and of those who weren't, about half wanted to start.
As far as surgeries go, only a small minority had actually gotten any
but most people wanted to. People assigned male
most commonly sought vaginoplasty
orchiectomy and facial feminization surgery.
With a bit over half wanting each one.
People assigned female most commonly sought top surgery.
16% had already gotten it, and those who hadn't,
about 60% wanted it too.
I'll remind you that we define youth as anyone between 14 and 24.
And everyone in that 16% was over 18.
The survey didn't ask people why they wanted to medically transition,
but it's not hard to guess.
Gender-affirming care is widely acknowledged
as a good treatment for gender dysphoria
and WPATH, as controversial as they may be,
say it's medically necessary for many people.
The survey found that youth who had gender-affirming healthcare
experienced less dysphoria than those who wanted to start but hadn't been able to yet.
Trans people know this. The whole point is to change sex traits
and ease a person's dysphoria.
Unsurprising but it's nice to see the numbers backing it up.
Those who knows me can attest to how much medical transition has helped me.
Before I got on hormones, I sleepwalked through my entire life
in this body that felt totally foreign to me.
That's a lot of stress for a young person to bear.
Once I started hormones at 17, it's like the fog lifted.
I can actually be a part of the world for the first time
and live with intent. I got to choose what kind of person I wanted to be.
I think that kind of agency is really empowering for a young person.
And then, a few years later, surgery took that even further for me.
Thanks to public healthcare, it was free!
Gender-affirming healthcare has helped me become someone I thought I could never be.
Someone who liked their life and their body!
Alongside measuring gender dysphoria,
the PULSE survey also measured gender positivity.
They found a correlation: youth who've had gender-affirming care
have more positive feelings about their gender.
It's safe to say mine have increased a fair bit.
The further I get into my transition, the surer I am
that everyone who wants to medically transition should have a chance to.
It should be cheap and straightforward and widely accessible.
People need it.
Healthcare is only one piece of the puzzle.
Even the post-transition among us are having a hard time these days.
We're all dealing with...
you know it. The "ongoing situations", let's call them. No need for reminders.
Gender-affirming care is one thing that all by itself can make a huge difference.
It's no wonder so many of us are passionate about it.
Also, it happens to be under attack all over the world right now.
I don't know if you've noticed.
Even in countries with public healthcare, it can be shockingly difficult to access.
And some people are trying to make it even harder.
In Canada, trans youth have some decent legal protections
and I don't think we're in imminent danger,
but the state of our health is nowhere near where it should be.
1/4 of us go without a family doctor,
1/3 of us languish on waiting lists
and nearly half of us have unmet health needs.
It's clear we have a long way to go. In the next episode,
we'll talk about barriers keeping trans youth from getting the care they need.
Things like waiting lists, income inequality and medical racism.
We'll also check out possible solutions to help bring those barriers down.
Follow the links in the description to watch and learn more.
This series was produced in partnership with Trans PULSE Canada.
While I took the lead on this project, their team analyses the data,
shared resources and their expert insight to bring everything together.
I wrote the videos with feedback by:
The data analysis was done by:
I also got to thank the expert freelancers:
Of course I wouldn't be here in the first place
without the kindness of my loyal patrons who has kept me going this year.
It was a team effort and I'm so grateful to everyone involved.
If you found the series interesting, head to:
and check out what else the team is up to. They put up infographics,
and really easy-to-understand reports about tons of interesting things.
Alright! See you in the next one!
And we're done. Thank goodness!
-Cut? -Cut!