Navigating Social Spaces includes information for Trans, Two-Spirit, and Nonbinary (TTNB) youth to consider related to coming out, accessing social support, safety, work, school, and travel. People may choose to come out as TTNB in some spaces and not others.
Seeking social support can be important for gender affirmation and navigating different life transitions. There are many things to think about regarding personal safety in different spaces and how to approach situations at work and school or when travelling. In this section, we address questions from Canadian TTNB youth about these topics.
Coming Out
Coming out to others, or inviting people in, describes the process of sharing that you are Trans, Two-Spirit, and/or Nonbinary (TTNB). People may first experience a process of gender exploration that includes coming out to themselves. Decisions about coming out to others are personal. Not everyone who is TTNB will come out to others. Some people come out to people who are close to them, and others come out publicly. Choices about coming out may depend on many things, such as relationships, safety, and gender health goals.
You should get to choose who you come out to, when you come out, and how you share your gender with others. For some people it is important to share with a few trusted people first, before coming out at school or work or in bigger social circles. It is important to consider whether you want to tell the people you are coming out that you would like them to keep this information confidential or if you want them to share it. Letting people know what you need can help you move at your own pace in the coming out process.
Coming out in relationships
Here are some things to think about when coming out to family members, friends, partners, and others:
- Who to come out to
- When to come out
- What to say to each person
- What resources are available for yourself and others, like counseling or peer support
- How to manage feelings during coming out conversations
- Wwhat to do if a coming out conversation becomes uncomfortable
- Having a support person to talk to about how a coming out experience went
- Recognizing there may be an adjustment period
- Celebrating important steps on your gender journey
Many TTNB people share advice about coming out through online articles and blogs. For example, some articles are about how to come out as nonbinary written by nonbinary people. Organizations like Planned Parenthood and the Trevor Project have guidebooks for youth on how to come out.
Another option for support is from a counsellor. A counsellor can also help you navigate old and new relationships while coming out. Please see the Mental and Spiritual care section for information on how to find a counsellor.
Please see the Work and School sections of this guide for more information on navigating coming out in these settings.
Coming out to providers
When it comes to healthcare providers, it is up to you to decide if, when, how, and to whom you would like to come out. However, if you choose to access gender-affirming medical interventions, you may need to disclose your gender to healthcare providers who are supporting you.
Youth may choose to share their gender with healthcare providers when:
- They are asking a healthcare provider to use new names or pronouns
- They are seeking support related to gender
- It feels like the most authentic choice for them
Some youth may choose not to share their gender with their providers because:
- They are concerned about privacy and confidentiality
- They are concerned about how their provider will respond
- They don’t feel any need to share this with their provider
If you decide to come out to a healthcare provider, there are some steps you can take to advocate for yourself:
- Call ahead and ask the healthcare provider’s office to update your name and pronouns before your appointment
- Share with the healthcare provider and/or staff how and when you want them to use your name and pronouns, for example, using one name in private appointments, and a different name when parents are present
- Ask about policies for supporting TTNB patients
- Bring a support person to help you talk to your provider and/or clinic staff
Resources
Human Rights Campaign Coming out at work: https://www.hrc.org/resources/coming-out-at-work
Planned Parenthood Coming out as trans and/or nonbinary
The Trevor Project Coming out: A handbook for LGBTQ young people: https://www.thetrevorproject.org/resources/guide/the-coming-out-handbook/
Trans Care BC’s Coming out: http://www.phsa.ca/transcarebc/gender-basics-education/terms-concepts/coming-out
Social Support
Social support can play an important role in Trans, Two-Spirit, and Nonbinary (TTNB) youth gender journeys. Social support describes love and care you receive from important people in your life. This may include family members, friends, partners, neighbours, school staff, co-workers, mentors, or healthcare providers.
Social support from others might mean:
- Listening without judgment
- Offering practical or emotional support or advice
- Checking in to see how you are doing
- Supporting you during appointments or meetings
Peer support
Peer support allows you to talk with someone who may understand your experiences and provide information and resources. Connecting with others who have similar experiences can help you feel understood and less alone. Peer support can happen in-person, over the phone, or online.
One way to find social support is to get connected to a peer support group. Some peer support groups are for youth in their teens, others are for older youth in their twenties and beyond. Some welcome family members or have separate meetings for family members. Support group sessions usually involve introductions, sharing how things are going, and discussion topics selected by a facilitator. Some groups may be able to help with transportation to and from meetings.
Online peer support directories:
Some provinces have online directories that are regularly updated where you can search for support groups for TTNB youth in your community. Directories are a useful starting point, but listings are not always guaranteed. Check beforehand with a group coordinator to see if a group will meet your needs (e.g., some are for youth only, and some are for younger youth and their families).
The Canadian Mental Health Association (CMHA) website has a ‘resources and information’ list for each provincial division through keyword search (e.g., “CMHA Alberta Division”). Each division’s site includes a list of societies,centers, alliances, and phone numbers that offer programs and services to TTNB youth.
TTNB youth-serving organizations
You can browse local TTNB organization websites to learn about what services are offered. This may tell you whether they offer support groups, whether they are facilitated by someone who is TTNB, how to find group meetings, and contact information if you have more questions.
School-based support
If you are a student at a secondary or post-secondary school, you may be able to find peer support through student GSAs, pride collectives, or other organizations. Some groups may offer support and others may be focused on activism and advocacy.
Phone support:
The Trans Lifeline provides crisis support for TTNB people by TTNB people at 877-330-6366.
The Lesbian, Gay, Bi and Trans Youthline offers free peer support for youth up to 26 years old at 1-800-268-9688.
Mentors
Another way to access social support is by finding a mentor. A mentoring relationship, unlike a support group, is usually one-to-one and involves connecting you with a TTNB person who is prepared to provide support around things like coming out, navigating relationships, and accessing gender-affirming care.
Availability of youth mentorship programs for TTNB youth may vary depending on your location. Many organizations that serve TTNB youth offer mentoring programs. Here are some examples:
- Mentor Canada is a coalition of organizations who provide youth mentorship
- The Trans Youth Mentorship program by the 519 (Ontario)
- The TransSupport program run by Plea Community Services (British Columbia)
- The Peer Support program and Community Coaching run by Skipping Stone (Alberta)
- The Ontario Mentoring Coalition
Indigenous youth
Agencies that provide programs and services for trans youth and gender-affirming Indigenous organizations may provide supports for Indigenous TTNB youth. Searching online for Two-Spirit spaces in your area can be a good starting point. You can also speak with community members, check with a local First Nations administration office, Band office in your area, or school guidance counselling office.
The following groups may help you connect with elders, spaces, and ceremony:
- Urban Native Youth Association (UNYA): A Vancouver organization with a range of services
that are Two-Spirit inclusive for Indigenous youth, some specifically for
Two-Spirit youth (see the 2-Spirit Collective) - Four Feathers Society
- Transforming Embers (for Coast Salish members/relatives)
- Greater Vancouver Native Cultural Society (GVNCS) social/cultural/community
- Two-Spirit Sweatlodge Ceremonies: Four Feathers Society or Capilano Reserve, Squamish Nation
- Dancing to Eagle Spirit Society: Tsleil-Waututh Two-Spirit and trans elder led ceremonies that are Trans inclusive and positive
- The National Association of Friendship Centres: See the website for a map of friendship centres across the country
- The First Nations Health Authority (FNHA): Involved in the delivery of First Nations health programs across British Columbia and offers a list of provincial and national resources
- The Native Youth Sexual Health Network: Run for and by Indigenous youth, engages in advocacy and activism in issues of reproductive and sexual health across North America
- Two Spirited People of Manitoba: Hosts projects and resources to create safe spaces for 2SLGBTTQIA+ community members, including a Two Spirit Sundance in August near Portage La Prairie, Manitoba which is open to youth
- 2 Spirits in Motion Society: Host projects, events, and resources for 2 Spirit people
- Edmonton 2 Spirit Society: Resources, programs, and events for 2SLGBTQ+ people, their family and community members
- 2-Spirited People of the 1st Nations: Greater Toronto area-based education and support for people living with or at risk for HIV and related infections
- Wabanaki Two Spirit Alliance: A volunteer group aiming to provide equitable and safe environments for Two-Spirit and Indigenous 2SLGBTQ+ people
- Two-Spirit Michif Local: a Manitoba Métis Federation in Winnipeg serving 2SLGBTQ+ Métis citizens
Support for loved ones
For some parents, caregivers, and loved ones, understanding and supporting a person’s gender journey may take time. Having access to trustworthy and accurate information and connecting with others who share their experiences can be helpful. Some support resources include:
Online resource guides for parents and caregivers
- “Families in Transition” is a guide for parents and caregivers of TTNB youth, developed by Central Toronto Youth Services. A free pdf is available online.
- The Family Acceptance Project is an organization that hosts videos and a resource guide on their website for parents and caregivers of 2SLGBTQ+ youth. The guide is available in English, Spanish, and Chinese, and focuses on concrete actions families can take to support a young person’s wellbeing in the context of their cultural and religious values.
- Qmunity has a support for parents resource
- Trans Care BC has a parenting section on their website
- Some websites have lists of resources for parents to learn more about parenting TTNB youth like the online support from the organization Supportive Parents.
In-person supports for family members and caregivers
- PFLAG Canada helps 2SLGBTQ+ people and their families through support, education, and advocacy. Their website has educational resources for parents like tips on how to support youth and themselves during the coming out process. PFLAG also connects parents of TTNB youth with other parents in the same community. Parents can be connected by finding a local chapter, becoming a PFLAG member, or becoming part of a national online community. Local chapters can be found by going to the PFLAG Canada site and navigating to the chapters or ‘contact us’ sections.
- The Families in Transition program is a 10-week group for parents and caregivers of TTNB youth which is offered by organizations across the country.
- Many local organizations offer regular drop-in groups for parents and caregivers. At some organizations, a drop in for TTNB youth might take place at the same time. These groups can often be found by searching online and/or reaching out to local 2SLGBTQ+ community organizations.
- Newcomer-serving agencies and organizations: Organizations that serve newcomers to Canada may have downloadable educational resources about being TTNB in multiple languages.
- Supportive healthcare or mental healthcare providers: Some families may be more comfortable getting information from a professional, like a doctor or mental healthcare provider. Supportive clinicians may be able to meet with family members to provide information, address their concerns, and emphasize the importance of supporting their youth.
Information for healthcare providers
Healthcare providers who do not have experience supporting TTNB youth but are open to learning may benefit from online resources. These guides are useful sources of information about gender and gender-affirming care that you can share.
- The World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transgender and Gender Diverse People (Version 8) offer guidance for healthcare providers to help patients reach their gender health goals
- The Endocrine Society publishes guidelines that cover puberty blockers and hormone therapy for TTNB people
- The Canadian Pediatric Society (CPS) has a position statement on providing gender-affirming care for TTNB youth
- Organizations such as Trans Care BC and Rainbow Health Ontario offer educational resources for healthcare providers
Online gender inclusive language guides
Many reputable organizations that serve TTNB youth offer online guides with information about why names and pronouns matter and how to use gender inclusive language. This information can help people understand the need to respect names and pronouns.
- Trans Care BC has an online guide for professionals on how to use pronouns, gender-neutral language, and honourifics in a respectful way.
- Statistics Canada offers an article on the importance of respecting personal pronouns.
- The Ontario Human Rights Commission has a Q&A section about pronouns, misgendering, and discrimination from a legal perspective.
Federal and international human rights laws and conventions
These resources can help people understand rights and protections for TTNB youth.
- The Canadian Charter of Rights and Freedoms, section 15, provides for equal protection under law related to sex.
- The Canadian Bar Association has a useful online toolkit on human rights in Canada.
- The United Nations Convention on the Rights of the Child (UNCRC):Article 2 describes the right of children to be free from discrimination based on sex or ‘other statuses.’ Article 3 describes that all actions concerning children must have the best interests of the child as their primary consideration. Article 6 describes the need to ensure the child’s development.
Resources
2-Spirited People of the 1st Nations: https://2spirits.org/
2 Spirits in Motion Society: https://2spiritsinmotion.com/
Canadian Bar Association. (n.d.). Questions and answers about gender identity and pronouns. https://www.ohrc.on.ca/en/questions-and-answers-about-gender-identity-and-pronouns#:~:text=Is%20it%20a%20violation%20of,factor%20in%20a%20person’s%20identity
Canadian Bar Association. (n.d.). Sexual orientation, gender identity and gender expression. https://www.cba.org/Publications-Resources/Practice-Tools/Child-Rights-Toolkit/theChild/Sexual-Orientation-Gender-Identity-and-Gender-Expr
Canadian Mental Health Association locator: https://cmha.ca/find-help/find-cmha-in-your-area/
Central Toronto Youth Services’ Families in TRANSition (FIT) program: https://ctys.org/services-programs/pride-prejudice/families-in-transition-fit/
Dancing to Eagle Spirit Society: http://www.dancingtoeaglespiritsociety.org/
Edmonton 2 Spirit Society: https://e2s.ca/
Four Feathers Society: https://fourfeathers.net/
Government of Canada (2021, March 15). The Canadian Charter of Rights and Freedoms. Department of Justice. https://www.justice.gc.ca/eng/csj-sjc/rfc-dlc/ccrf-ccdl/
Greater Vancouver Native Cultural Society’s (GVNCS) Facebook page: https://www.facebook.com/gvncs78/
Mentor Canada find a mentor: https://mentorcanada.ca/en/take-action/find-mentor
Native Youth Sexual Health’s peer support manual: https://www.nativeyouthsexualhealth.com/peersupportmanual
PFLAG Canada chapter locator: https://pflagcanada.ca/chapters/
PLEA’s TransSupport program: https://www.plea.ca/transsupport/
Rainbow Health Ontario (2016). Families in transition: A resource guide for parents of trans youth. https://www.rainbowhealthontario.ca/resource-library/families-in-transition-a-resource-guide-for-parents-of-trans-youth/
Skipping Stone’s Peer Support and Community Coaching programs: https://www.skippingstone.ca/programshttps://www.skippingstone.ca/programs
Statistics Canada (2023, October 18). Pronouns: They matter. https://www.statcan.gc.ca/o1/en/plus/4762-pronouns-they-matter
The 519’s Trans Youth Mentorship program: https://www.the519.org/programs/tymp/
The National Association of Friendship Centres: https://nafc.ca/friendship-centres/find-a-friendship-centre
The Ontario Mentoring Coalition guide for mentoring LGBTTQQIP2SA youth: https://ontariomentoringcoalition.ca/mentoringyouthfacingbarriers/tailored-mentoring-for-youth-with-specific-needs/lgbttqqip2sa-youth/
Trans Care BC Gender-Affirming Health Benefits for Indigenous Clients Seeking Care: https://www.transcarebc.ca/sites/default/files/2024-03/Indigenous_gender-affirming_health_benefits.pdf
Trans Care BC Two-Spirit: https://www.transcarebc.ca/information-for/indigenous-people
Trans Lifeline: https://translifeline.org/
Transforming Embers: https://transformingembers.com/
Two-Spirit Michif Local: https://2smichiflocal.ca/
Two-Spirited People of Manitoba: https://twospiritmanitoba.ca/
United Nations. (1989). Convention on the Rights of the Child. http://www.ohchr.org/en/professionalinterest/pages/crc.aspx
Urban Native Youth Association: https://unya.bc.ca/
Vandermorris, A., & Metzger, D. L. (2023, Jun20). An affirming approach to caring for transgender and gender-diverse youth. A position statement by the Canadian Pediatric Society. https://cps.ca/en/documents/position/an-affirming-approach-to-caring-for-transgender-and-gender-diverse-youth
Wabanaki Two Spirit Alliance: http://w2sa.ca/
Youthline: https://www.youthline.ca/
Safety
Public spaces
Many public spaces are affirming of Trans, Two-Spirit, and Nonbinary (TTNB) youth. However, if you find yourself in a space or situation that feels less safe, there are things you can do to respond and protect yourself.
One important step you can take is to be aware of your surroundings. Limiting distractions (such as looking at a cell phone or using headphones) and traveling in well-lit areas where there are plenty of people are recommended, especially at night.
If a situation makes you feel unsafe, leave as quickly and calmly as possible and get help. If your safety is threatened, go to an area where there are many people (e.g., a restaurant or mall) and find ways to draw attention (such as yelling, or shining a bright flashlight).
There are free applications like bSafe that allow you to send your location to trusted contacts or send an SoS to those contacts after a certain period. Calling a trusted friend or family member (while keeping one ear open) can also be a deterrent until you are in a safer place. Remember, discrimination, harassment, and violence are never your fault.
Home
Youth may live in supportive homes or live in places that are less accepting or safe. If your home environment is unsupportive, you can try protecting your wellbeing by setting boundaries through choosing who you spend time with, how much time, and how often. You can also set boundaries by asking others in the home not to discuss topics that might be sensitive or likely to lead to dispute. This may or may not work, depending on the living situation.
According to Canadian law, there is a duty to report if a child or minor youth is being mistreated. This can be reported to local child welfare authorities, provincial ministries/departments, or local police by a youth, a healthcare provider, a teacher, or anyone else who is aware of the mistreatment. Through this process or other organizations, TTNB youth may be able to find different living situations where they will be better supported.
Online
Online spaces can be important for many TTNB youth to find information, connection, and community. However, TTNB youth may sometimes have negative experiences online. This section includes tips on how to stay safe online.
TTNB youth deserve privacy and are generally safer when they use their own devices others do not have access to. Be aware of who might have access to the devices you use and how that might affect your safety and privacy. The safest way to do this is to use a personal computer or smart phone in the home that is protected with a password or passcode. Be aware that downloading files onto a computer can leave a record on the hard drive even after the files are deleted.
To stay safe online, do not give strangers personal information like your name, date of birth, home address, phone number, identity documents, financial information (bank or credit card), or any other information that could be used to identify you, like where you go to school or work. It is safest to assume nothing shared online is private. One suggested rule is to avoid sharing any photos or information online that you would not be comfortable showing people at work or school.
Given the rise of anti-trans messaging on social media and targeted harassment like doxing (revealing the home address of a person) and SWATting (making a false report to police to activate a local SWAT team), protecting identifying information is important. One strategy is to remove the geo-location data from your photos before posting online. Many phones now have support for removing this data before photos are posted. Neutral usernames may make TTNB people less vulnerable to targeted mean-spirited or hateful comments or direct messages (DMs).
If you receive negative comments or harassment, here are some options:
- Ignore or delete the comment or DM
- Report the comment to whoever runs the service, site, or platform (e.g., forum moderator). Certain platforms have policies against hate speech and harassment of protected groups.
- If the online harassment is by people you know offline (e.g., peers at school, coworker), you may choose to address this offline by reporting the harassment to an adult at school or supervisor at work.
If you are exposed to online anti-trans messaging, you can choose to:
- Ignore it: choose not to respond or “don’t feed the trolls”, as responding may lead to further anti-trans comments. You can also block specific users to prevent further engagement.
- Take a break: stepping away, taking a deep breath, engaging in relaxation or meditation exercises may be useful to buffer against negativity. Going for a walk or doing something else that is enjoyable may help you re-focus on positivity. It can also be important to reconnect with the physical world when negativity piles up online.
- Talk to a supportive person: talking through upsetting content can be helpful with a supportive friend or family member.
- Enhance privacy settings: you can adjust settings on social media apps to limit interactions to individuals you know and trust.
If you decide to respond to anti-trans messages, it is important to consider what the toll will be on you and what is to be gained. It can be difficult to allow anti-trans messages to go unchallenged, especially when directed at yourself or a loved one. Strategies to consider include seeking out support from trusted friends and taking care of your own emotional and mental well-being when encountering hateful content.
Reporting a crime
If a person is the victim of or witness to a crime, they can make a report to the police by calling 911 or visiting a police station in person. It is important to note involvement with the criminal justice system can be a long and emotionally difficult process for anyone. TTNB and racialized people are more likely to have negative experiences with police like being treated disrespectfully or not having their concerns thoroughly investigated. As a result, some individuals make the choice not to report a crime.
If you choose to make a police report, keep detailed notes about what happened and a record of the police officer’s name and badge number. You should also receive a case number for the report so you can keep track of what the follow-up is. If you are not treated respectfully or your concerns are not taken seriously, you can file a police complaint. This process will vary by jurisdiction.
Resources
bSafe download: https://www.getbsafe.com/
Canadian Child Welfare Research Portal (n.d.). Frequently asked questions.
James, A. (n.d.). Transgender online safety. Transgender Map. https://www.transgendermap.com/guidance/social/safety/online/
James, A. (n.d.). Transgender personal safety. Transgender Map. https://www.transgendermap.com/guidance/social/safety/
Trans Hub (n.d.). Boundaries. Trans Vitality Toolkit. https://www.transhub.org.au/vitality/boundaries
Trans Rights BC (n.d.). Police & Prison System. https://www.transrightsbc.ca/know-your-rights/police-prison-system/
Transgender map blog by Andrea James: https://www.transgendermap.com/
Work
Coming out at work
There are many reasons for coming out or for choosing not to come out at work. If you decide to come out at work, here are some things to consider:
- Planning: It can be helpful to outline goals, identify next steps and prepare to respond to questions. Preparation can be empowering. This can be done both individually and in collaboration with a trusted colleague, supervisor, or HR representative.
- Gathering support: You may be able to identify allies in the workplace (e.g., colleagues or HR staff). Some workplaces may have diversity committees or opportunities to connect with other 2SLGBTQ+ staff.
- Trusting your instincts: if it feels unsafe, you may choose to not come out in the workplace.
Transitioning in the workplace
There is no one right way to transition at work. Some people transition slowly over time, and others may come out to everyone at once. How each person approaches transitioning at work should be based on their comfort levels and individual needs.
If you decide to transition at work, you can ask to meet with your supervisor or HR representative to develop a plan and identify who can support you. The plan may include things like updating workplace documentation or wearing a uniform that is gender-affirming.
If you would like to change your name, your supervisor or HR representative can also help make updates to things like internal forms, work email addresses, and ID badges. Some government forms and payroll information will have to use a person’s legal name. If you legally change your name, you should inform your employer immediately to update documentation. This is important for things like making sure the name on your pay cheque matches what is on your bank account. Your employer may require proof of the legal name change.
You have the right to take a leave from work for medical treatment related to transition. Employers do not need to know any specific details about the kind of treatment or procedure an employee is having. However, employers will need to know:
- When you are requesting time off
- How long you need to be off work;
- Whether the procedure might affect your ability to do your job, and if so, how;
- Whether you will need any accommodations when you return to work.
Healthcare providers may provide you with medical documentation for your employer outlining the required information.
For information about rights and privacy in the workplace, please see the Rights, Advocacy, and Allies section of this guide.
Resources
Baboolall, D., Greenberg, S., Zucker, J., & Obeid, M. (2021, November 10). Being transgender at work. McKinsey and Company. https://www.mckinsey.com/featured-insights/diversity-and-inclusion/being-transgender-at-work
Folx Health How to come out as trans at work: https://www.folxhealth.com/library/how-to-transition-at-work
HRC Foundation. (n.d.-a). Gender diversity in the workplace: A transgender & non-binary toolkit for employers. https://hrc-prod-requests.s3-us-west-2.amazonaws.com/files/assets/resources/2023-Workplace-Equality-Transgender-Toolkit-PDF-For-Employers.pdf
HRC Foundation. (n.d.-b). Transitioning in the workplace: A guide for trans employees. Human Rights Campaign. Retrieved January 8, 2024, from https://www.hrc.org/resources/transitioning-in-the-workplace-a-guide-for-trans-employees
HRC Foundation. (n.d.-c). Workplace trans inclusion: Recommended policies & practices. Human Rights Campaign. Retrieved January 8, 2024, from https://www.thehrcfoundation.org/professional-resources/transgender-inclusion-in-the-workplace-recommended-policies-and-practices
Supporting transgender and gender diverse employees in the workplace. (n.d.). British Columbia Public Service. https://www2.gov.bc.ca/assets/gov/careers/all-employees/working-with-others/gender-diverse-workplace.pdf
Trans Care BC, Coming out: https://www.transcarebc.ca/explore-transition/coming-out?term=comingout
Trans Rights BC, Employment: https://www.transrightsbc.ca/know-your-rights/employment/#:~:text=The%20right%20to%20equal%20access,or%20because%20someone%20outs%20us
School
Coming out at school
Some Trans, Two-Spirit, and Nonbinary (TTNB) people come out at school and others choose not to. Here are some things to consider about coming out at school:
- Planning: It can be helpful to outline goals, identify next steps and prepare to respond to questions. Preparation can be empowering. You can do this both individually and in collaboration with a trusted friend, family member, advocate, teacher, or healthcare provider.
- Gathering support: You may be able to identify allies at school. Some schools have GSAs, diversity committees, and opportunities to connect with other TTNB students.
- Trusting your instincts: if it feels unsafe, you may choose not to come out at school.
Medical leave
Many people take time off school for medical reasons. For older TTNB youth, this can include time for transition-related medical treatment like gender-affirming surgeries. School administration and instructors do not need to know details about what procedures or medical treatment youth are accessing.
For youth in post-secondary school, there may be Academic Advisors who can help provide information about available accommodations. They can also give advice on taking time off from school for medical treatment. Depending on the length of time required, post-secondary students may choose to take formal medical leave from their studies.
For youth with government student loans, there are rules about medical leave relating to student status and loan payments. Academic or Financial Advisors on campus can provide more information on a case-by-case basis. General information can also be found online through Employment and Social Development Canada.
School administered insurance plans
Many post-secondary institutions offer extended health insurance plans for their students. The specific details about what is covered by the plan will vary by school. Some plans may explicitly cover gender-affirming medical interventions and others may not. If gender-affirming medical interventions are not listed in the coverage, some costs may still be covered under other categories (e.g., prescription medications). You may need to speak directly to an insurance representative about your specific coverage needs.
StudentCare, a service that brokers insurance for many post-secondary students across Canada, has a gender-affirming care benefit that schools can opt into. While many student plans still do not cover gender-affirming care, institutions across Canada have begun to enroll in this benefit. If you are planning to access gender-affirming medical interventions during your studies, learning more about student health insurance plans could help you make a decision about where to study.
For information about rights and privacy at school, please see the Rights, Advocacy, and Allies section of this guide.
Resources
Albright, R. (2023, October 4). Creating an LGBTQ+ inclusive workplace: Nurturing acceptance & celebrating diversity. https://www.inclusionhub.com/articles/creating-an-lgbtq-inclusive-workplace-nurturing-acceptance-and-celebrating-diversity
Employment and Social Development Canada’s Student Loans: Medical and Parental leave overview: https://www.canada.ca/en/services/benefits/education/student-aid/grants-loans/medical-parental-leave.html
Fuller, P. (2023, November 30). Inside the fight to add gender-affirming care to university health insurance plans. Xtra Magazine. https://xtramagazine.com/health/trans-health-insurance-university-260108
Gender-affirming health care. (n.d.). UBC Equity & Inclusion Office. Retrieved January 8, 2024, from https://equity.ubc.ca/resources/gender-diversity/transgender-health/
People Corporation. (2023). Gender affirmation care. Green Shield Canada. https://studentcare.ca/RTEContent/Document/GAC/Gender%20Affimation%20EN.pdf
StudentCare by province at a glance: https://studentcare.ca/RTEContent/Document/GAC/EN_Gender_Affirmation_Care_Eligible_Procedures.pdf
Trans Rights BC, Education: https://www.transrightsbc.ca/know-your-rights/education/
Travel
Safe travel
Laws and social acceptance related to gender vary in different countries and regions. For example, some countries do not legally recognize Two Spirit, trans, and nonbinary (TTNB) people. It is always a good idea to know what your rights are within a destination country. However, knowing your rights is not a guarantee that everyone you encounter will uphold them.
Anyone traveling outside of Canada is subject to the laws of the countries they travel through, even if these laws infringe their human rights. The Government of Canada has travel advisories on their website that are regularly updated. You can review this list before making travel plans. You should also learn about a country’s laws and customs before your travel there.
Some countries do not have discrimination protections for people. This means people may legally be refused service, or their gender may not be respected. In the United States, for example, the Transportation Security Administration (TSA) may disregard gender markers and screen individuals based on the TSA officer’s perception, or a screening machine’s guess of a person’s assigned sex. This affects full-body scans and pat downs at security checkpoints. To avoid being identified as TTNB, some people decide to travel with a passport sex/gender marker that aligns with how others perceive them.
In some countries there may be an increased risk of discrimination in medical settings, including being refused care due to being TTNB. You may want to get legal advice before you travel outside of Canada.
Reaching out to people who have travelled to or live in the places you plan to visit may be helpful. They may be able to share experiences related to laws and customs in specific places. Racialized youth may be at greater risk in some places. Gathering information about risks and safety tips can help you make informed decisions about where to travel and how to keep yourself as safe as possible.
Some strategies to stay safer while travelling may include:
- Travel as part of a group.
- Be aware of your social media presence. Information made public online may be accessed by local authorities.
- Be cautious using the internet and your phone while travelling. Local police may be able to use cell phones to track your location and websites you visit.
- Consider how others may perceive your gender and whether being identified as may increase your risk of discrimination, harassment, or violence.
- Be cautious of public displays of affection that may be perceived by others as non-heterosexual.
- Be careful if connecting with people you have met online, as some people may target people using fake online profiles.
If you are a Canadian citizen or permanent resident outside Canada and need help, reach out to a consulate or the Government of Canada’s Emergency Watch and Response Centre. Consular officials may be able to help you if you have experienced harassment, violence, or inappropriate treatment. They can also help if you are arrested, detained, ill, injured, if you need to be evacuated in an emergency, or if you face an international custody problem.
X gender markers
Gender markers are displayed on most legal identification documents, including passports. The Canadian government allows you to choose an X as your gender marker. Federal, provincial, and territorial laws protect people in Canada from discrimination based on gender identity or expression. These laws should protect people who travel within Canada with an “X” gender marker on their identification documents, but TTNB people may still face discrimination while travelling.
People whose passports have an “X” sex or gender marker may experience challenges when travelling to countries that do not recognize this marker. They may be denied entry or asked to provide binary sex information. You should get advice about the implications for your ability to travel outside of Canada if you have, or are considering getting, an X gender marker on your passport.
Travelling with medication and medical supplies
Some people need to travel with medications and supplies related to their gender health. Medication should be in its original container with the original prescription label. The name on the bottle should match the name on your ID and your ticket. Medications that are clearly labelled can make screening at airports easier. A doctor’s letter is not required to carry needles on a plane, though some people choose to travel with a “carry letter” from their doctor.
Some countries limit the amount of certain medications a person can bring into the country before requiring an in-country prescription. For example, Canada does not allow a person to bring more than 30 days of a controlled substance (e.g., testosterone) into the country. Individuals must get a local prescription if they have a longer stay. Some over the counter medications available in Canada are illegal in some countries. Get advice about your medications before you go.
In all instances, medications should be packed in a single bag in an easy-to-reach location for screening purposes. Medication should generally be kept with you, to protect it from theft, loss, extreme temperatures, or long travel delays that might make you miss a dose. If possible, syringes should be in checked luggage rather than with you, for example, in your carry-on luggage.
Travelling to or through the United States
When travelling by plane to the United States, there is a limit on the amount of liquids you can take through the security checkpoint, called the 3-1-1 rule. For trips routed through or arriving in the United States, liquid medications are currently exempt from the 3.4 oz (100 mL) limit but must be declared at the security checkpoint. The 3-1-1 Liquids Rule Exemption states that some items can be carried on a plane, as long as each item is declared and is:
- required during your flight and/or at your travel destination;
- not available at the airport in the sterile area (after the screening checkpoint) and/or;
- not available at your travel destination.
The TSA Notification Card for Individuals with Disabilities and Medical Conditions (also called the blue card) is a free, downloadable and printable card for individuals whose disabilities or medical conditions may affect screening to provide information to TSA agents. This card will not prevent screening or a search. However, it can provide a way to discreetly explain medication(s) or medical equipment you are traveling with. It is recommended to use this card if you are travelling with any medical equipment that could flag a body scanner or appear suspicious in a bag scan. This includes breast forms and packers worn on the body.
Resources
Government of Canada Travel and tourism (2024, February 13). Travel advice and advisories by destination. https://travel.gc.ca/travelling/advisories
Government of Canada Travel and tourism (2023, February 15). Travel and your sexual orientation, gender identity, gender expression and sex characteristics. https://travel.gc.ca/travelling/health-safety/lgbt-travel
Transportation Security Administration (n.d.). Travel checklist. https://www.tsa.gov/travel/travel-tips/travel-checklist#:~:text=Liquids%2C%20gels%20and%20aerosols%20packed,1%20bag%20per%20passenger
TSA Notification Card for Individuals with Disabilities and Medical Conditions. https://www.tsa.gov/sites/default/files/disability_notification_card_508.pdf
https://www.cbc.ca/news/politics/global-affairs-lgbt-unitedstates-warning-1.6950833https://travel.gc.ca/travelling/health-safety/lgbt-travel
Disclaimers
We published this guide in 2024. We know that laws, policies, and options for healthcare change over time and vary across provinces, territories, and Nations. To find specific information for your region and to keep up to date on changes that may affect you, look for trustworthy resources near you. This guide is not intended to provide medical or legal advice. If you have questions about accessing gender-affirming healthcare for yourself or a loved one, we encourage you to reach out to a trusted healthcare provider or organization.
More Resources
For a downloadable version of this guide, quick reference infosheets and our community report, please visit the Just Be Yourself Resources page.
Copyright
Copyright 2024 under a Creative Commons license CC BY-NC-ND 4.0.