Gatekeeping and Structural Violence in Accessing Gender-Affirming Experiences and Support Among Trans and Gender Diverse Youth in Quebec


Jada Joseph, Concordia University

The current model of trans healthcare practised in Quebec involves trans people obtaining permission from a psychologist, sexologist, general practitioner or in some instances a social worker to access gender-affirming care (GAC). Medical science upholds the binary system by suggesting that most trans people desire medically transitioning from one binary gender to another; thus, requiring ones “transness" to be attested by health practitioners; the gatekeepers. The truth is rarely recognized as residing within trans and gender diverse people; thus, to access GAC, ones narrative must align with that upheld by the medical community. The authority of medical science and health practitioners is most apparent amongst trans and gender diverse youth who are at risk of experiencing childism in addition to other systems of oppression. Young-Bruehl (2013) defines childism as “prejudice against children,” in which the rights of children are dismissed due to the “prejudicial assumption that children are possessions of adults and thus do not have rights” (p. 4 &10). While navigating western institutions, the needs, and voices of trans and gender diverse (TGD) youth may be silenced to prioritize the opinions of their parents and the health practitioners who seek to uphold cisnormativity. This presentation provides a brief historical presentation of policies that lead TGD youth in Quebec to experience structural violence and human rights violations. Following is a review of the literature on the need to depathologize trans experiences and honour the self-determination of youth. The authors also present two alternative models to trans healthcare, the informed consent model and the gender-affirming model. Both models have promise in shifting away from paternalistic modes of care and t transforming trans healthcare at the micro and macro level.

This paper will be presented at the following session: