5 Background


2021 marked the first time that Canada collected and presented census data that reflected transgender and non-binary people. This landmark publication showed that 0.33% of the Canadian population, or 100,815 people, aged 15 or older living in a private household do NOT identify as binary or cisgendered. That incidence increases to just under 1 person for every 100 aged 20-24 years of age. These statistics are also geographically linked, with higher proportions of transgender and non-binary individuals living in Nova Scotia, Yukon and British Columbia (Government of Canada, 2022). Additionally, 19% of BC high school students identify as gay, lesbian, bisexual or not exclusively heterosexual. As well, Aboriginal students are 5 times more likely to identify as two-spirited than the overall high school population does as transgender (First Call, 2018). This revelation points not necessarily to an increase in incidence, but a recognition of previously marginalized people.

Impacts on Health and Well-being:

Despite the knowledge that a significant proportion of Canadians do not identify as binary or cisgendered, these individuals are statistically under-served in health care and education, which may lead to an increased risk of mental and physical health adverse outcomes. Statistics Canada reports that 65% of people identifying as transgender or non-binary had poor or fair mental health, vs 11% in cisgendered individuals, and were nearly 3 times as likely to have seriously contemplated suicide in their lifetimes Government of Canada, 2022). In lesbian, gay and bisexual youth, the likelihood of attempted suicide increases to 7 times that seen in heterosexual youth (First Call, 2018).

Attitudes and discrimination has contributed to these outcomes in both health care and health care education. Clarke, Veale, Greyson and Saewyc report that transgender adolescents were more likely to forgo or delay seeking care for both physical and mental health issues from a primary care provider due to fears of judgement from health care professionals or prior negative experiences (2017). These cultural biases on which fears and negative experiences are based could be due to such factors as only 0.16% of all scholarly articles in popular nursing journals have a Sexual Orientation-Gender Identity (SOGI) focus, and in nursing schools in the United States only 2.12 hours are spent on SOGI content (Ziegler, Charnish and DeCianits, 2022).

All of this points to the need to make health care and education more culturally safe and inclusive.


Aisner, A. J., Zappas, M., & Marks, A. (2020). Primary Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ) Patients. The Journal for Nurse Practitioners. https://doi.org/doi:10.1016/j.nurpra.2019.12.011

Clark, B. A., Veale, J. F., Greyson, D., & Saewyc, E. (2017). Primary care access and foregone care: A survey of transgender adolescents and young adults. Family Practice, 1–5. https://doi.org/doi:10.1093/fampra/cmx112

Government of Canada, S. C. (2022, April 27). Canada is the first country to provide census data on transgender and non-binary people. The Daily – . Retrieved May 30, 2022, from https://www150.statcan.gc.ca/n1/daily-quotidien/220427/dq220427b-eng.htm

Resources and facts on sexual orientation and gender identity (SOGI) in schools. First Call. (2018, January 17). Retrieved May 30, 2022, from https://firstcallbc.org/news/resources-and-facts-on-sexual-orientation-and-gender-identity-sogi-in-schools/

Ziegler, E., Charnish, E., & DeCiantis, N. (2022). Out of the closet: Nurse practitioner faculty knowledge, comfort and willingness to incorporate LGBTQ2SA content into the curriculum. The Canadian Journal of Nursing Research, 12(1), 1-7. doi: 10.1177/08445621211073289.


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