Gender-affirming care (GAC) has long been a vital service offered by the Wellness Hub. Over 150 trans patients currently rely on the Wellness Hub for Hormone Replacement Therapy (HRT) and other GAC practices. Amidst the numerous advances in McGill’s GAC practices, The Trans Patient Union (TPU), a McGill student coalition run by and for trans and non-binary patients, continues to advocate for the improvement of trans healthcare services. The TPU has long-standing concerns about the state of GAC at the Wellness Hub, which is becoming increasingly relevant as patients face new issues with receiving gender-affirming care.
As of late December, family physician Dr. Hashana Perera, the Wellness Hub’s primary GAC doctor, has gone on maternity leave and will not be back until January 2026. Dr. Perera was responsible for providing Hormone Replacement Therapy (HRT), surgery readiness assessments, and other trans healthcare services alongside local wellness advisor Margot Nossal. During her absence, Dr. Perera’s patients have been redirected to the Hygea endocrinology clinic.
The Wellness Hub told the Daily that they have a “multifaceted plan to provide care during Dr. Perera’s leave” and have been “building capacity through training and increasing options for care.” Nonetheless, the TPU has expressed that this redirection of services is an additional obstacle for trans patients seeking GAC and HRT services.
The TPU claims that since any general practitioner can supervise and administer HRT in Quebec, “it is an unnecessary burden on endocrinology clinics to exclusively shoulder this responsibility.” They added that “as specialized medicine, endocrinology is harder and slower for patients to access than general practice.” Multiple healthcare providers at Hygea have also recently gone on parental leave, adding an additional strain on their staff amidst an influx of new patients.
As of mid-January, the waitlist for HRT at Hygea was over a year long, a considerably longer wait than for any other endocrinology services at the clinic. According to the TPU, this means that patients referred to Hygea at this time will likely not be able to receive service at the clinic until after Dr. Perera returns from her leave.
According to a statement given by the TPU to the Daily, Wellness Hub employees told the organization in January that no plans had been made for other staff at the Hub to take over Dr. Perera’s role in administering HRT. However, in a more recent statement to the Daily on February 21, the Hub said that other medical staff are currently being trained in facilitating HRT and administrating other trans care services. The reason for this change is unclear. In January, the TPU claimed on Instagram that, to their understanding, Hub doctors have had access to and, in some cases, not taken various opportunities to learn how to provide HRT. Rather, the TPU states, “it simply seems that many doctors at the Hub, and in Quebec, do not believe that providing care to trans people is their job.”
The Wellness Hub also told the Daily that they have recruited a new family physician with seven years of experience in GAC services, who they hope will begin work at the Hub by mid-March. The TPU claims that the head of the Hub told them via email in January that they intend to find new providers, but the TPU has doubts after the same promise was left unfulfilled last year.
The TPU continues to meet with members of the Wellness Hub at least once a semester to discuss issues raised by patients on access and medical practices. In an official statement given to the McGill Reporter and shared with the Daily, the organization said that the dialogue with Hub employees over the years has been encouraging, and that they have been happy to see specific providers demonstrate a willingness to improve and develop trans patient care.
In 2022, the TPU interviewed over 25 trans patients to produce a comprehensive list of proposed changes to improve the GAC services at the Wellness Hub. They worked alongside SSMU, HealthQueer Professionals, and Community Educators for Healthcare Improvement to ensure the representation of trans voices in wellness spaces at McGill. Despite important victories over the past three years, the TPU claims that there is still much progress to be made in adequately addressing issues raised by patients.
The TPU has already raised various questions about the efficiency of HRT services at the Wellness Hub, and, as stated to the Daily, has made Hub employees aware of the precarity of having only one doctor providing HRT. Simultaneously, the TPU continues to have grievances and concerns about GAC at the Wellness Hub. In a statement posted on Instagram, the TPU discussed the limitations of trans health services available to McGill students, including: that the HRT process is unnecessarily long, that there is only a narrow range of HRT medications available to transfeminine patients, and that 17-year-old patients cannot access their right to consent to HRT until their 18th birthday — despite the medical age of consent being 14 in Quebec.
These grievances come directly from the patients the TPU represents. A series of anonymous interviews conducted by the TPU for the McGill Reporter raise various issues with GAC practices at the Wellness Hub, including practices that do not align with international recommendations set by the World Professional Association for Transgender Health. The six-month wait period to begin HRT (beginning from when the patient had come out or begun socially transitioning), and a visual inspection of the chest wall and physical examination of the genitals for patients seeking feminizing hormone therapy, are two Hub policies which have been dropped after meetings with TPU representatives. That being said, as of December, the Hub still required a minimum of three appointments to receive a prescription, even when patients presented a consent form at their first appointment.
“I think in general there needs to be greater understanding and recognition of trans patients’ perspectives on their own medical care,” shared a former undergraduate student who received HRT, referrals for surgery, and mental health services at the Wellness Hub from 2022-2024.
“I think it would be beneficial to see more doctors able to provide gender-affirming care at the Wellness Hub, though I know this is easier said than done,” a current student added.
The TPU continues to remain in contact with the Hub, which has been made aware of their concerns. The Union has also been in communications with Student Services and Provost Angela Campbell, and hope to meet soon with Dr. Vera Romano, Director of the Wellness Hub. In this time of change among GAC practices, The Wellness Hub has stated that they will continue to correspond with the TPU, keeping them informed of recruitment efforts and developments during Dr. Perera’s leave.
Gender-affirming care goes beyond HRT services. In Dr. Perera’s absence, the Wellness Hub continues to offer support services to LGBTQ+ students: students can meet with Local Wellness Advisors who provide psychosocial support, book appointments with counsellors and sexologists, and refer to Access Advisors in navigating care and support. For trans students struggling in the wake of recent changes made by the Wellness Hub, the TPU offers a plethora of resources for support, healthcare, and gender advocacy.