Is mental health care availability for Ontario transgender and bisexual women the same as the rest of the population?

A new study finds that transgender and bisexual women in Ontario are not receiving the mental healthcare services that they need, a sign of systemic exclusion from mental healthcare in Canada, say the study’s authors.

Evidence suggests that sexual minorities including gay men, lesbians and bisexuals as well as gender minorities such as transgender people all face more mental health struggles than do heterosexual among the population. Increased risk for depression, completed suicides and suicide attempts as well as other forms of self-harm are all in higher rates among sexual and gender minorities. A recent study, for example, found that suicidal thoughts were reported by 36 per cent of transgender people in Ontario and past year suicide attempts were reported by 10 per cent.

These high numbers are coupled with significant socioeconomic hurdles faced by bisexual and trans people, says the Canadian Mental Health Association, which points out that bisexual and trans people are over-represented among low-income Canadians, with half of trans people in Ontario currently living on less than $15,000 a year.

Thus, the need for access to mental health services is great for sexual and gender minorities, yet there is surprisingly little research available on access rates for two of the most vulnerable groups, namely, bisexual women and transgender people.

“Very little research has examined rates and predictors of mental health service access among bisexual women and transgender people (the highest need groups) in particular,” say the authors of a new study published in the Journal of Women’s Health. “A lack of access to inclusive mental health services may be a contributing factor in the elevated levels of depression, suicidality, and other mental health concerns among these populations.”

The study recruited 704 sexual and gender minority people and heterosexual cisgendered adult women from Ontario and found that bisexual women were 1.8 times more likely to report an unmet need for mental healthcare in comparison to heterosexual women, and trans participants were 2.4 times more likely to report such a need as cisgender women. Trans participants were also 1.6 times more likely to report untreated depression.

The numbers show that Ontario’s mental health system is currently not meeting the needs of many sexual and gender minority people, say the study’s authors, who go one step further to suggest that the results are at least in part explained by social factors such as experiences of discrimination, lower levels of social support and “systemic exclusion from healthcare.”

“These findings suggest a need to explore models of mental healthcare that can more adequately address the experience of social exclusion that may be fundamental to meeting the mental health service needs of LGBT people,” say the study’s authors.

The results come as the federal government plans to issue an apology to the LGBTQ community for what it sees as years of discrimination. In November, the government appointed Edmonton MP Randy Boissonnault as special adviser to the Prime Minister on LGBTQ issues, with the notion of an official apology clearly on the agenda. “We have to address the historical wrongs because the government did some terrible things to really good people,” said Boissonnault, who states that an estimated 9,000 federal public servants were forced out of their jobs between the 1950s and 1990s because of their sexual or gender identity or orientation. “This is our community’s opportunity for a truth and reconciliation process where we can really listen and be able to respond respectfully and appropriately as a government,” Boissonnault said

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