‘Health-care systems are not built for us’: LGBTQ+ people struggle to get good care

TORONTO — A new report says LGBTQ+ people in Canada aren’t getting access to the health care they need — including mental-health treatment —compared to the general population.

The Pink Paper on Health, released by Pink Triangle Press on Thursday, says mental health and gender-affirming services were the most prevalent concerns identified by LGBTQ+ people in a national survey.

Almost 40 per cent of LGBTQ+ participants reported having a mental health disorder, including anxiety and depression, compared to 20 per cent of heterosexual, cisgender participants.

Report co-author Nadia Bouhamdani said many Canadians are struggling with their mental health right now but she didn’t expect to see such a dramatic spike among the LGBTQ+ population.

On top of a shortage of mental-health care providers overall, the report said, many aren’t adequately trained to meet the needs of transgender and non-binary people in particular.

When the researchers broke down the survey results into different communities under the LGBTQ+ acronym, they found that gay men had similar levels of both anxiety and depression as the heterosexual population.

Pansexual, asexual, questioning, transgender and two-spirit people had the highest levels of anxiety. They also had, along with lesbians, relatively high levels of depression.

The report didn’t address why gay men appear to have a lower level of mental distress than other LGBTQ+ communities, but Bouhamdani said those with gender non-conforming identities — including trans, non-binary and two-spirit people — are at particular risk of experiencing discrimination, stigma and a lack of access to health care that feels safe.

Racism adds another layer of discrimination, she said, recalling a striking comment from an Indigenous two-spirit participant in the study.

“It was basically ‘if I get sick, I prefer just staying home and … I do not want to enter the health- care system here because of so many experiences of discrimination,”” said Bouhamdani, who is a researcher in Moncton, N.B., specializing in health inequities for marginalized populations.

One of the main recommendations in the report is to integrate training on the needs of LGBTQ+ patients into the curriculum for health-care professionals, including in medical and nursing schools.

The report also recommends increasing access to publicly funded mental-health care and incorporating mandatory training in LGBTQ+ care.

Ziya Jones, who identifies as queer and non-binary, said the study is a “really good starting point” to addressing the disparities that exist for LGBTQ+ patients and hopes it translates into action.

“Generally the health-care systems are not built for us,” they said.

Jones said they have personally felt “reticence” in the past when seeking mental-health care.

“[I’ve] met with therapists who didn’t necessarily have the language to speak about, you know, my personal experiences or who might have been sort of uncomfortable or didn’t necessarily know how to relate to sort of what was going on in my personal life,” said Jones, who lives in Montreal and now goes to a health clinic specializing in LGBTQ+ care.

Jones, who is the managing editor of a new Pink Triangle Press LGBTQ+ health information website called Script, said although people sometimes face “blatant homophobia or transphobia” from health-care providers, they are more often turned away from care because the provider doesn’t feel qualified to treat them.

“I think generally speaking, health-care professionals don’t feel that they have received enough training to treat … trans and non-binary people who are seeking gender-affirming care. And they may not even be necessarily aware of some of those spots where they don’t have the knowledge.”

Dr. James Owen, a family physician working with LGBTQ+ patients at a St. Michael’s Hospital clinic in Toronto who was not involved in the report, said the findings “unfortunately” don’t surprise him.

“I would say that the majority of patients who I work with have probably had some sort of negative experience in health care, either overt or subtle stigma, discrimination, or just simply a health-care provider who doesn’t fully understand how to meet their needs,” he said.

The Temerty Faculty of Medicine at the University of Toronto, where Owen is an assistant professor and director of the second-year program, has implemented a mandatory gender-diversity curriculum to prepare future doctors to provide care to LGBTQ+ patients.

The report provides more evidence that those patients “do have unmet health needs across the spectrum of health care and that there does continue to be a need for the health-care system to step up,” Owen said.

“I don’t expect every health-care provider to be an expert in trans and gender diverse health … but there are basic building blocks that every health-care provider should know to create that culturally safe environment for patients.”

Pink Triangle Press commissioned Environics Research to conduct the online survey of more than 2,100 Canadian adults between March 19 and April 13, 2025.

The participants included 1,062 people identifying as LGBTQ+ and 1,048 heterosexual, cisgender people.

The polling industry’s professional body, the Canadian Research Insights Council, says online surveys cannot be assigned a margin of error because they do not randomly sample the population.

Environics Research also did 16 virtual one-on-one interviews with health-care leaders, medical students, researchers, specialists in LGBTQ+ care and Indigenous people to delve more deeply into some of the issues identified in the survey.

This report by The Canadian Press was first published Jan. 29, 2026.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Nicole Ireland, The Canadian Press