Mr. Speaker, health care is a shared responsibility between the Government of Canada and the provinces and territories. The federal government’s primary role in supporting health care is to provide funding to the provinces and territories, while the provincial and territorial governments administer and deliver health care services.
The Canada health transfer, or CHT, is the largest federal transfer to provinces and territories. It is the main federal funding mechanism that supports Canada’s health care system by providing long-term predictable funding to provinces and territories.
The CHT is legislated to increase each year, growing in line with the economy, with a minimum increase of at least 3% per year, while its equal per capita distribution across provinces and territories ensures comparable treatment for all Canadians, regardless of where they live. Budget 2023 outlined the government's plan to provide close to $200 billion in health care funding over 10 years, including $46.2 billion in new funding to provinces and territories through the CHT and other targeted funding.
The Canada Health Act establishes criteria and conditions that provinces and territories must fulfill in order to receive their full CHT cash contribution. Notably, the act does not stipulate specific procedures to be covered. Rather, the provinces and territories, in consultation with the medical profession and other health professionals, determine which services are considered medically necessary and therefore to be covered under their respective health care insurance plans. Any health service that has been deemed medically necessary by a province or territory must be delivered in a manner that meets the requirements of the act, on uniform terms and conditions, and without patient charges.
Regarding funding for two-spirit, lesbian, gay, bisexual, transgender, queer, intersex, and additional sexually and gender diverse people, or 2SLGBTQI+, Health Canada’s sexual and reproductive health fund supports community-based organizations that help make access to abortion, gender-affirming and other sexual and reproductive health care information and services more accessible for underserved populations, including two-spirit, trans and non-binary, or TTNB, young people and their families. Through budgets 2021 and 2023, $81 million has been committed to the fund over six years.
Since its creation in 2021, three organizations have been funded for projects focused on improving access to gender-affirming care.
Trans Care B.C. has received almost $6.9 million for two projects that help address barriers to accessing gender-affirming health care and health disparities experienced by TTNB people. To address discrimination and lack of provider knowledge, educational resources have been developed for health care providers and TTBN people living in B.C. By sharing knowledge and research related to best practices, the ongoing project is also addressing misinformation and disinformation campaigns that are active in B.C. and across Canada, which affect TTNB children and youth and are a barrier to care for 2SLGBTQI+ communities and caregiver decision-making.
Hamilton Trans Health Coalition has received just over $15,000. Their project, completed in June 2023, engaged Canadian gender-affirming health care providers to identify the scope of harassment, intimidation and threats they experience, and to highlight best practices and strategies to address them.
Sherbourne Health centre has received approximately $569,000. Their project, completed in March 2024, addressed the gap in access to inclusive, comprehensive sexual and reproductive health care for 2SLGBTQI+ communities by advancing the capacity of health care providers to competently provide safe, affirming and accurate information and service provision.
Canada’s federal health research funding agency, the Canadian Institutes of Health Research, or CIHR, has invested over $59 million in research, training and capacity building related to 2SLGBTQI+ health over the past five years, which includes gender-affirming care.
As an example, through the national women’s health research initiative, enabled by a budget 2021 investment of $20 million and launched in 2022, CIHR is leading a national, coordinated research program that aims to advance and mobilize knowledge to improve women’s and gender-diverse peoples’ health outcomes and health care. This initiative promotes an intersectional lens to research and care to tackle persistent gaps for all women, including for transgender, queer, intersex, and additional sexually and gender diverse communities.
For more information regarding CIHR research on gender-affirming care, please see its database of funding decisions.
Women and Gender Equality, or WAGE, supports organizations that serve 2SLGBTQI+ communities. Since 2021, WAGE has invested approximately $10.5 million in 36 organizations that proactively include transgender people within their reach of services and those solely working with this population.
As highlighted in budget 2023, the Government of Canada plans to introduce a new action plan to combat hate that incorporates addressing hate faced by 2SLGBTQI+ communities. This new action plan will include measures to combat hateful rhetoric and build safer, more inclusive communities.