Health committee  It's a term that gets used sometimes for those who would be on the autism spectrum, or have diversity in how their brains work. Interesting numbers are being seen in the research literature around those who are neurodiverse more prominently presenting as gender-diverse as well. Sometimes that presents a barrier for a young person in getting care, for example, because they will find there is much more gatekeeping around accessing gender affirmation because they may also have an autism diagnosis.

Health committee  The pathways are really variable for people, so it's a really hard point to speak to. I think, as you heard, the journey is very long for people. Often, someone might think for a long time about coming out and talking to a professional, and then the search to find that first professional can take a long time.

Health committee  In B.C. the genital surgeries are funded by MSP, which is our provincial insurer, and they have an agreement with the Montreal clinic to pay for services there.

Health committee  Education is needed broadly from the age of day care through to the rest of our lives. Young people get gendered and start getting put into those gender boxes right when they start encountering, sometimes at the hospital when we think about what people ask when babies are born: Is it a boy?

Health committee  That's a big question. I'll start with indigenous communities, and I'll speak to the B.C. context, because that's where we're working. B.C. has 203 first nations. To begin to understand how Trans Care BC as a program can be relevant to the communities in B.C., we've taken our time to travel, to introduce the program and to try to understand by having direct conversations with people who will show up and meet with us about the intersections of colonization and gender and how colonization has impacted gender.

Health committee  In B.C. it has been essential to undergo policy, service planning and educational resource development work by including, consulting and directly collaborating with those who have trans lived experience. This includes youth, adults, parents, caregivers, indigenous trans and two-spirit communities.

Health committee  Lastly, we want to highlight the diverse needs of gender-creative and trans children, youth and their families. Psychosocial care, peer support and access to health care are key determinants of health for trans and gender-diverse children and youth. We know from research that many young people do not feel it's possible to tell their health care providers about their gender if they are trans or non-binary.

Health committee  Thank you for the invitation to be here today. We're greatly honoured to have travelled here from Vancouver, B.C., where the two of us work on unceded indigenous territories of the Squamish, Musqueam and Tsleil-Waututh nations. I'm Lorraine Grieves, provincial program director with Trans Care BC.

Health committee  I feel very privileged to be the program director, as a Cree Métis and British Columbian. I also identify as two-spirit, and am the proud parent of a 29-year-old. We've submitted a brief for your reference, with 10 recommendations in it, and we'll be focusing our presentation today on health and wellness for transgender, gender-diverse and indigenous trans and two-spirit individuals in Canada.