“I feel strongly that my role is to help people on an individual level. But ultimately, if you do that enough, you’re helping groups and you're making a difference on a wider scale.”

In 2016, just after Dr. Sonya Malone had been appointed medical director of Western’s Student Health Services, she was asked to consider how the university could better support gender-diverse students and students requiring medical transition counselling.  

Sonya and her colleagues met with representatives of Pride Western and Spectrum, Western’s 2SLGBTQ+ campus advocacy group, and upon hearing their concerns, she had to agree.

“I really wasn’t aware of this population’s needs. In that moment, I realized I had had blinders on.” But that realization also acted as a turning point for Sonya. “I looked those students in the eye and said, ‘I promise you I will do better, and we will do better as a clinic.’”

Sonya and the team of family physicians, psychotherapists and psychologists contacted Rainbow Health Ontario, a Toronto-based group that provides education and resources to the gender-diverse community and to medical providers. Soon, the Western health services team developed a program that included medical and psychological care, hormone prescribing, surgical referral and management of surgical complications.

“We put an ad on Rainbow Health Ontario’s website saying Western had launched a trans care team. A few days later, someone came to see me and said they had been looking at the Rainbow Health website and, in seeing our ad, knew it was now time for them to transition.”

Since that launch in 2016, Sonya says feedback from clients of the trans health program has been positive. “Students have said they never thought they could start their medical transition in university. They assumed they’d be referred by a doctor like me to someone outside the university and then they’d have to wait and wait long past graduation.”

But launching the program was only the first step. “The plan had always been for trans health care to not be a specialization in our clinic. We needed it to become a standard component of our primary care services. We want every health provider in our service to have gender-affirming care as part of their core competency.”

That improves health care for everyone, Sonya says. And it makes a statement.

“When we distribute gender-affirming care among all our providers, it means we’re further normalizing the idea that humans are gender diverse, that it’s not abnormal to be trans and non-binary, that it is a normal variation of human diversity.”

Sonya, who is now a family physician working in occupational medicine at Western, is glad students who wish to transition now have a medical team on campus that can help them. “One student said to me, ‘I came to Western because of the trans care.’  That made me happy and sad. Students shouldn’t have to consider what type of medical care they can get on campus to determine which university is a good fit for them.”

“This is absolutely the right time to make innovative changes in primary care to support trans and gender-diverse patients. We all need to put on the jets and do this work publicly and make gender-affirming care a normal part of our work as medical professionals.”