Seven years ago, Simon Rayek was rushed to a Vancouver emergency room to ask for the post-exposure HIV drug PEP — CBC News reported.
Rayek thought he had been exposed to the virus, but when he asked the doctor for the medication, the doctor knew nothing about it. Also, to his dismay, he found the doctor condescending and felt he asked uncomfortable questions.
"That really was the reason that I even became involved in the field I'm in," Rayek told CBC News. He's now the health promotion program manager at Health Initiative for Men (HIM), a non-profit organization helping queer men and gender-diverse people in British Columbia.
Rayek now spends his time helping others navigate the healthcare system. His career has helped him discover that the LGBTQ2+ community was being pushed aside in Canadian health long before COVID-19.
The Ministry of Health said the province is trying to make its healthcare more inclusive. It told CBC News that it plans to change language use across policy programs and resources and be "trauma-informed, gender-affirming and gender-additive." The Ministry will also facilitate increased access to services for the LGBTQ community.
Although Rayek thinks the work is a great idea, it doesn't change the fact that there is a shortage of Canadian doctors who have the necessary knowledge of LGBTQ2+ healthcare.
"When you have 10 percent of physicians in Canada who feel knowledgeable about queer and trans-specific health care ... you also have to do the work to actually get the people offering services to be able to speak the language and reflect the policy changes being made," said Rayek.
A trans man named Wyatt Maddox told CBC News one of the major deterrents for him was finding a general practitioner with basic knowledge of trans people's needs. This includes surgical planning, post-op care and hormone medications.
Maddox said it took a while to get the gender-affirming surgery moving, and there were administrative mistakes that kept delaying the process.
"It was a regular timeline of about a year to a year and a half. It ended up being over three years for me," said Maddox.
In a statement, Trans Care B.C. said it has developed ways for healthcare professionals across the province to feel more confident in providing gender-affirming care in a primary care environment. The government organization supports care delivery, surgical planning and community support for trans people in British Columbia.
"I really haven't seen that happening. I see more and more people online who are in search of any doctor that can provide them with the health care that they need," said Maddox. He added that based on his experience, there is a lack of stable supply of testosterone for trans men in B.C.
"On almost a yearly basis, those go on backorder. So when we don't have a supply of this medication, it can have some really negative health effects, including [that] it can be fatal," said Maddox.
"I do know a lot of people who will end up sharing supplies and taking less than they need, and that can be really detrimental."
According to Rayek, some people are unsure about talking to a medical professional, which leads to greater challenges causing higher depression rates, suicide and substance use.
"We, I think as a community, often will not seek out the medical treatment that we need to address those things," said Rayek, pointing out that this causes most people to not stay on top of their sexual health.
The pandemic closed three sexual health HIM clinics in the Lower Mainland, creating another obstacle for access.