By: Tejasvita Saini, SFU Student and Antonia Chircea, SFU Student
Content warning: mentions of anti-Indigeneity, medical trauma, forced sterilization, and transphobia.
Healthcare perpetuates many inequities. From sexism, racism, queerphobia and transphobia, to ableism — it can be hard to access the care you need due to systemic barriers. In what ways do these barriers show up for patients? What ideas and prejudices perpetuate the mistreatment of certain groups in healthcare, and how can this be solved?
Tejas: We hear so much praise of Canadian healthcare, but many overlook the complex systemic inequalities that people of colour, women, people with disabilities, Indigenous people, and 2SLGBTQIA+ people face. The praise of Canada’s healthcare system silences the voices of those who do face inequalities in healthcare.
Antonia: As a person who works in healthcare, I’ve seen how outdated ideas and prejudices directly impact a person’s ability to access the care they need. New doctors time and time again turn down people seeking gender affirming care as a result of inexperience. Which, in this case, brings up the question: what is being taught to doctors in school? Despite the fact that the medical field is one where change should be embraced, I have seen many doctors hesitate to try new drugs or procedures. This tendency to stick to old ideas leads to a plethora of topics typically being taught from a white, cisgender, man’s perspective.
Tejas: In Saskatchewan, a doctor was able to forcefully sterilize new Indigenous mothers by coercing them. Many women were asked for their “consent” for this procedure while they were in active labour, under the influence of pain drugs such as an epidural. They were also given disinformation like the procedure being reversible. The lawsuit notes this happened to at least 20 women, some of whom did not consent and were sterilized anyways.
These violent, anti-Indigenous procedures occurred between 2005–2010, continuing a decades-long trend of forced sterilization. While many may think we have moved toward reconciliation and that anti-Indigenous sentiment is just a dark part of Canada’s old history, they would be shocked to find themselves ignorant to the reality of discrimination and injustice toward Indigenous people, and especially Indigenous women.
Antonia: While many people may brush off the example just given as an extreme that certainly can no longer be happening, when looking deeper we can see that microaggressions toward Indigenous people are still worryingly prevalent. Around 44% of First Nations people said they felt discriminated against from the years 2014–2019, according to Statistics Canada.
This discrimination tends to come to light in the medical system when Indigenous folks ask simple questions regarding certain aspects of healthcare. Dealing with government paperwork is not easy. When a majority of people ask for clarifications regarding these forms they have no problems receiving a response. Unfortunately, the same cannot be said for Indigenous peoples. When an Indigenous person comes in and inquires about anything, I often see them met with eye rolls and sarcastic scoffs from doctors and receptionists alike. Naturally, this creates a barrier to information, which is completely based on prejudice.
Tejas: Healthcare can be a very sensitive and crucial part of someone’s life. Nobody likes going to the doctor or the hospital, but they deserve a doctor and medical staff who ease their anxieties — not build upon them. Not only is this leading to a skew in the treatment of certain groups like Indigenous people and trans people, but it’s also making these communities more apprehensive to use Canada’s universal health care and seek access to a basic human right.
Antonia: On top of Canada not being able to provide adequate care to those whose lands we live on, we also seem to have difficulty providing care to other marginalized groups. While in Canada there are organizations that provide trans youth with gender affirming items such as binders, we cannot deny that trans people still face numerous barriers stopping them from getting the gender affirming care they need.
While cis people have easy access to a wide array of hormonal contraceptives not requiring any parental consent, trans people in Canada still require parental approval to even begin the process of physically transitioning. For youth, this involves taking puberty blockers for a few years before the individual decides if they want to stop taking hormones altogether, or swap to taking estrogen or testosterone. A glaring issue with hormonal transition needing parental consent is the fact that some parents refuse to help their children start their transition, and as a result many trans children have no option other than to live in mental anguish until they are old enough to access this care on their own. Not to mention that the process of receiving hormone replacement therapy itself is fraught with more barriers than it should be, the first being doctors. As was mentioned above, doctors tend to receive an education focused on gender binaries, and many new doctors are too nervous and inexperienced to help trans people start their transition, thus turning them away.
More experienced family doctors tend to scoff at the large amount of paperwork required, and they too end up turning people away. It is for that very same reason that many walk-in clinics also tend to turn away trans people seeking care. All of these factors combined make it virtually impossible for trans people who are of age to even start their transition, much less those who are younger than 18. If the process was more streamlined, perhaps this wouldn’t be an issue, yet the system itself is the one causing these barriers, and ultimately it needs to be the one to change.
Tejas: Not only are trans people facing discrimination within the healthcare system, but they’re having trouble finding access to a doctor with the proper training and mindset to treat them. This tells us that the problem is not in just a few “bad” doctors but in the very way people are taught to be doctors. How can doctors treat patients who have been fundamentally excluded from their training and knowledge? Is Canadian healthcare universal when so many groups are excluded from receiving care within it?
