Some students are reporting increased difficulties accessing gender-affirming care following the temporary leave of Hashana Perera, reportedly the only doctor at the Student Wellness Hub (SWH) willing to prescribe Hormone Replacement Therapy (HRT). For some, this has called into question the ability for the SWH to provide specialized resources for transgender students.
HRT is a medical treatment and a form of gender-affirming care used to augment levels of specific hormones in the body. According to an official statement from the Trans Patient Union (TPU)—a student organization dedicated to advocating for better healthcare for transgender patients in Montreal—those requiring HRT will now be referred to the Hygea endocrinology clinic for treatment. Students have reported wait times of over three to six months at this clinic for the first of three mandatory appointments they must attend before they can receive a prescription for HRT.
TPU addressed concerns about patients being referred to an endocrinologist in a written response to The Tribune. The Union claimed that the Hygea clinic is currently understaffed and therefore ill-prepared to manage both their current patients and the Hub’s referrals.
“In Quebec, any general practitioner can prescribe and supervise HRT—it is an unnecessary burden on endocrinology clinics to exclusively shoulder this responsibility, and as specialized medicine, endocrinology is harder and slower for patients to access than general practice,” TPU wrote.
The union wrote that they have previously expressed concerns to the SWH about the instability of having only one doctor available to prescribe HRT. During Perera’s previous temporary leave, another doctor at the SWH stepped in to provide HRT and other gender-affirming care for students. TPU was reportedly told by SWH employees that more doctors would begin to take on the appropriate training to prescribe this medication. Despite this, the SWH currently has no plans to have another doctor take on this responsibility during Perera’s absence.
In addition, Perera was also the only doctor at the SWH able to provide recommendation letters for gender-affirming surgeries, a requirement to accessing surgical transition in Canada and a service Hygea is unable to provide.
In a written statement to The Tribune, the McGill Media Relations Office (MRO) stated that the SWH will continue to provide HRT to patients with preexisting prescriptions and that, in the future, they plan on hiring more doctors able to provide the same services as Perera.
MRO also commented on gender-affirming care at the SWH prior to Perera’s leave, stating that they have always been dedicated to prescribing HRT in a way that prioritizes students’ wishes.
“Specific medication prescriptions are individualized based on many factors but especially the individual patient’s goals of treatment,” McGill wrote.
Despite this, students reported that accessing HRT at the SWH was challenging even prior to Perera’s leave. In an interview with TPU, one student—who wished to be unnamed—reported that the SWH refused to prescribe them above the minimum starting dose for two years, despite the student wanting to increase the dosage over time.
“I felt that my experience was subpar compared to every other care experience I have had before and after attending the Hub,” the student said. “I am very frustrated that I am further behind in my medical transition than I would have been if I had received better care.”
TPU states that while the wait time for gender-affirming treatment at the SWH has gotten shorter over the last few years, the lack of another doctor in light of Perera’s leave has set back this progress dramatically, leaving transgender students at McGill with unreliable and inaccessible gender-affirming healthcare.
“Unfortunately, it simply seems that many doctors at the Hub, and in Quebec generally, do not believe that providing gender-affirming care is their job,” TPU wrote.
Those seeking gender-affirming care can self-refer to Local Wellness Advisors (LWA) or Access Advisors, including one LWA that specifically serves 2SLGBTQIA+ students. Students can also book appointments with a Counsellor or Sexologist at the SWH to navigate services and access support. TPU additionally offers a resource index for gender-affirming care and more on its website.
