Towards a Regional Strategy on Gender Inclusivity

2021, Innovations in Research

This project will improve the overall quality of the health care and workplace experience for transgender, non-binary and two-spirit (TNB2S) patients and employees in the Fraser Health region, and address the barriers they face to accessing services.

The experience of patients and employees who are part of the TNB2S population is characterized by exclusion and inequitable access to care and other services. Although currently hidden, the severity of the harm and negative impact that exclusion and inequity is having on the health, well-being and quality of life of these individuals cannot be overlooked. Engaging patient partners and TNB2S employees in this project will provide the benefit of moving the project in the right direction with the inclusion of those perspectives and hearing from lived experiences.

This project focuses on the exploration of issues related to gender diversity. There is value in doing this focused deep dive because of the distinct nature and gravity of systemic issues facing TNB2S patients and employees that impact their health and well-being. By paying attention to this under-served and heretofore invisible subpopulation, it is hoped to better understand and address the many unique and nuanced barriers that TNB2S people navigate on an ongoing basis while accessing and working within the health care system.

Throughout the consultation process, we have engaged with patients and staff of Fraser Health to determine and highlight the barriers and inequities faced by the TNB2S population both in health care and employment.

After identifying these barriers and inequities, this project will also develop a thorough set of recommendations to develop policies and procedures to remove, or at least minimize, these barriers. With a research-focused approach, we also aim to measure the impact of these new policies and procedures on the experiences of TNB2S patients and employees.

This project will make Fraser Health a welcoming, inclusive and safe place for TNB2S patients and employees—improving experience and access to care and services.

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About the project

Presentation at Innovations in Research, April 13, 2021

Moji Adurogbangba
Michelle Green

BC SUPPORT Unit Fraser Centre

Gender, inclusion, health, employment, diversity

Quotes from research participants

“I come armed with information, because I don’t trust doctors will know [about trans health needs]. … I feel fortunate that based on my professional background, I can read and understand the science … but what happens to someone who cannot [advocate for themselves]?”

– TNB2S Patient Interviewee

“I had a social worker when I was in the Intensive Care Unit ask what my pronouns were and went out of their way to create a sign above my bed to show others that my pronouns are them/them/their. I really appreciated this gesture and it made me feel like my pronouns were respected and that there was an effort made so that others respect my pronouns.”

– TNB2S Patient Survey Respondent

“I used to always address patients as Mr., Mrs., Miss, etc., as I thought it was respectful. I have now learned to address patients by their first name. I wish there was an option on our requisitions and documentation where the patient could state their lived name as it is sometimes different than what their legal documents say.”

– Employee Survey Respondent

“I believe that in the case of medical records you need to have correct information… as it might affect the care he requires in an emergency situation when he is unable to speak for himself. Knowing he is prescribed testosterone subcutaneously weekly may affect treatment provided and I would hope if he were in a hospital that his hormone therapy would be continued if he could not speak for himself.”

– Employee Survey Respondent

“It’s small missteps that accumulate and bubble over. The reaction from a TNB2S person may have little to do with the Fraser Health staff, but a whole set of challenges that get too much for the individual to bear. … It is OK if Fraser Health staff do not know everything about transgender people. The important thing is if their heart is in the right place and they are open to learning from and listening to transgender people.”

– TNB2S Patient Interviewee

“It is difficult and uncomfortable to explain that I identify as a man and have female anatomy. I do not want to explain every time what my anatomy, issues and needs are.”

– TNB2S Patient Interviewee


Mojisola (Moji) Adurogbangba

Moji Adurogbangba (she/her/hers), BDS, MPH, MA (Bioethics), is the System Level Ethicist with Fraser Health Ethics Services. She promotes and advances ethical decision-making in Fraser Health through the consult process leading to development and/or review of policies, practice guidelines and strategies.

Michelle Green

Michelle Green (she/her/hers), BPsy, MGH, is the Project Coordinator for this project. She works with Fraser Health Ethics and Diversity Services to support the coordination and implementation of projects aiming to improve how we provide care to a diverse population and staff.

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