Gender affirming substance use care for trans and gender diverse youth

Runtime: 36:51

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SHOW NOTES

Summary

In this episode, journalist David P. Ball is joined by Dr. Marcus Greatheart, a family physician, registered social worker, and author. Together, they explore how clinicians can create safe and affirming spaces for trans and gender-diverse youth in substance use care by addressing systemic barriers, promoting trauma-informed approaches, and challenging fear-based narratives. They also speak with Toby and Alec, members of the Substance Use Beyond the Binary Youth Action Committee at the BC Centre on Substance Use. Drawing from their lived experiences with substance use and barriers to gender-affirming care, Toby and Alec offer valuable insights into navigating the healthcare system. Finally, David and Dr. Greatheart hear from family physician Dr. Andrea Moir, who shares lessons from her work providing gender-affirming care for young people. Dr. Moir discusses the impact of stigma, the importance of nonjudgmental approaches, and practical steps clinicians can take to foster more inclusive healthcare environments.

We extend a special thank you to Christian Barborini for their dedication in supporting engagement with the Substance Use Beyond the Binary Youth Action Committee at the BC Centre on Substance Use. Their work was instrumental in facilitating the participation of Alec and Toby in this episode.

Learning Objectives

Understand the unique challenges that trans and gender diverse youth experience in accessing gender-affirming care, including systemic barriers, stigma, and discrimination.
Describe approaches to delivering accessible, affirming, and equitable substance use care for trans and gender-diverse youth, including identifying and addressing logistical and systemic barriers to care.
Recognize the importance of providing non-judgmental, individualized care by actively listening, meeting youth where they are in their relationship to substance use, and tailoring support to their unique needs and experiences.
Describe the value of transparent and collaborative communication strategies for all clients, especially trans and gender-diverse youth, which foster trust when asking sensitive questions and support continuity of care through thoughtful handovers.

Lineup

In this episode, you’ll hear:

2:15 – Dr. Marcus Greatheart, Co-host –Author; Registered Social Worker; Family physician, North Island Gender Clinic, Vancouver Island
7:00 – Toby, Guest – Member of the Substance Use Beyond the Binary Youth Action Committee, BC Centre on Substance Use
7:00 – Alec, Guest – Member of the Substance Use Beyond the Binary Youth Action Committee, BC Centre on Substance Use
20:28 – Dr. Andrea Moir, Guest – Family physician, Trans Specialty Care and Foundry, Vancouver

Clinical Pearls

Here’s what listeners can take away from this episode:

Creating a safe and affirming environment for patients is essential. Approach care with open-mindedness, compassion, empathy and understanding. Taking even a few extra minutes to listen and understand a patient’s experiences can significantly improve trust and engagement.
Be intentional with communication. Clinicians should be mindful not only of what they communicate but how they do it. Using person-centred, inclusive, and affirming language in referral letters, conversations with colleagues, and thorough documentation all contribute to ensuring gender-affirming and stigma-free care.
Consider and address barriers to care. Social and physical barriers must be addressed but also financial and logistical ones that youth may experience. Offering proactive support, such as connecting patients with social workers or peer navigators, can improve access to care.
Take time to ensure thoughtful care transitions. When referring patients to other providers or when youth are aging out of services, proactive communication (e.g., warm handoffs, detailed notes, personal follow-ups) helps maintain trust and continuity of care.