Quality Standard Details
Gender-Affirming Care for Gender- Diverse People: Care for Adults
- Publication Date
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2024-August-01
- Status
- Published
- Topic Area
- Reproductive System and Hormones
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In Ontario, gender-diverse people experience inequities in accessing health care, which negatively affects their experiences of the health care system and their health outcomes. The 2021 Canadian census indicated that approximately 1 in 300 people in Ontario identified as transgender or nonbinary, and the need for gender-related care within the primary care system is growing.
Gender-affirming primary care can be improved by establishing a welcoming, safe environment that is respectful of all gender-diverse people and by using gender-affirming, inclusive language. In addition, gender-affirming medical interventions can reduce the psychological distress that gender-diverse people may experience by supporting the alignment of their physical appearance with their gender identity.
This quality standard addresses care for gender-diverse adults aged 18 years and older. The term "gender-diverse" refers to all people whose gender identity or expression differs from the gender typically attributed to the sex assigned to them at birth. The term is inclusive of all Two-Spirit, trans, and nonbinary people. The quality standard focuses on gender-affirming care and the primary care needs of gender-diverse people, including assessment, screening, treatment, and follow-up. It addresses referral for gender-affirming surgery, based on clinical evidence, but not specific surgical procedures.
Although many statements may apply to intersex people, this quality standard does not directly address the care of intersex people.
Quality Standard in Brief
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Quality Statement 1: Gender-Affirming Education and Training for Health Care Teams
Gender-diverse adults receive care from clinicians who have the clinical and cultural competency and cultural humility to provide safe and appropriate gender-affirming care. Health care organizations provide ongoing gender-affirming education and training for health care teams to build organizational capacity to deliver equitable care.
Quality Statement 2: Gender-Affirming Primary Care
Gender-diverse adults receive appropriate and compassionate gender-affirming primary care health assessments, screening, treatment, and follow-up. This care is based on their needs and preferences and is appropriate for their age, gender, and current anatomy.
Quality Statement 3: Gender-Affirming Hormone Therapy
Gender-diverse adults have access to gender-affirming hormone therapy from a primary care clinician. Gender-affirming hormone therapy meets the needs and preferences of gender-diverse adults.
Quality Statement 4: Gender-Affirming Mental Health Care
Gender-diverse adults are offered trauma-informed, person-centred, gender-affirming care for mental health and substance use concerns as needed. These concerns are considered concurrently with gender incongruence and gender diversity as needed. Care for all aspects of health and well-being is delivered as part of a comprehensive care plan.
Quality Statement 5: Gender-Affirming Health Care Environments
Gender-diverse adults receive care in a safe, trauma-informed, gender-affirming, and culturally responsive environment. Person-centred care is provided throughout their care journeys.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
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- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
