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For Hillary Werth, who grew up in a conservative U.S. household, moving to Canada two years ago was a new beginning… a rebirth.

Shortly after arriving in Canada to get married, Hillary (who also goes by Hill), was finally able to admit that they thought they are trans or non-binary.

“It was really hard to say out loud to myself, and to my wife,” said Hill. “I always used she/her pronouns and said I didn’t really care, but I did. If a server asked me and my wife ‘Are you ladies ready to order?’ I had a cringe feeling and hated being called that. I had ignored those feelings for so long, but when I started acknowledging them and being true to myself, that was the start of a new beginning.”

On July 27th, Quinte Health’s Diversity, Equity and Inclusion (DEI) Committee hosted “A Discussion on Gender Identity” with guest speaker, Hill Werth (they/them), a trans, non-binary mixed media artist who uses their art and voice to spread visibility and awareness and to represent their community.

The purpose of Quinte Health’s DEI Committee is to raise awareness, provide learning opportunities, and help our organization build and sustain a diverse, equitable and inclusive workplace. Dr. Erin Falconer, Family Medicine physician and member of the DEI Committee, hosted the discussion and interviewed Hill. With approximately 100 staff members and physicians in attendance, it’s fair to say that the DEI Committee was successful in its goal of raising awareness and promoting discussion on gender diversity.

During the discussion, Hill shared that being new to Canada, and without a family doctor, they didn’t know where to look for gender-affirming care. Getting accustomed to a new country is hard enough (Hill hadn’t even heard of a Loonie or Toonie before arriving) but navigating the Ontario healthcare system was painful.

“I just started Googling,” said Hill.

Hill first found the Transgender Health Program through Kingston Community Health Centres (KCHC), which helps with the referral process and coordination of care for clients seeking gender-affirming medical care, but Hill faced a long waitlist.

Hill’s next search brought them to a family physician who offered a drop-in centre, three hours per week. Hill went back week after week, but the doctor had never cared for a trans patient before and needed time to educate herself.

Upon hearing of Hill’s experience during the discussion, Dr. Falconer, who finished medical school in 2012, agreed that physicians often don’t have the education or training needed to assist with gender-affirming care. “In medical school, I didn’t have any classes on gender diversity—maybe one or two lectures—but I didn’t learn the how-tos of prescribing hormones etc. I’ve had to seek out education through Rainbow Health Ontario. I think these days it’s a little more embedded in the medical school curriculum.”

Guest speaker Hill Werth (left) and Dr. Erin Falconer (right) discuss gender diversity during a presentation at Belleville General Hospital.

As a student at Queen’s University (Hill is studying to become a teacher), Hill has access to the Student Wellness Centre, and met a doctor there that has been amazing in guiding them through the gender-affirming process. Things have moved along fairly quickly now, but Hill admits that their situation isn’t typical.

“My experience, and how quickly I’ve been able to start this and how quickly I’ve been approved for top surgery consultation, is not the norm,” said Hill. “It usually takes years. And people die during that time because they’re like, ‘I can’t do this anymore.’”

Hill doesn’t plan to transition fully to male. They just want to develop a more masculine physique (fat distribution to reduce their natural hips) and is on a weekly dose of testosterone to achieve that. The next step will be top surgery, hopefully by the end of 2023.

“I can’t wait to have top surgery,” said Hill. “I refuse to go swimming, it’s so uncomfortable. I’ve been slumping my shoulders forward to hide my chest my whole life.

I just want to mow my lawn without a shirt on,” Hill joked.

“We live in a very binary world,” said Dr. Falconer. “All of our societal structures are around that. The human experience of gender is actually much more expansive, fluid and variable. Binary is just two identities but to be human is to have a much more variable understanding of gender identities.”

Hill agreed. “Everyone thinks that your gender identity and your physical appearance have to add up, but the cool thing is that you don’t have to choose male or female. People get caught up on they/them being plural but it’s 2023 and language has evolved so much. I don’t ever expect people to be perfect on pronouns—just ask if you don’t know. It’s more uncomfortable not to address the elephant in the room. The more we talk about it, the more comfortable it will be.”

Denise McGuire, an RN in the Recovery Room at Belleville General Hospital, spoke up to thank Hill for helping to educate us. She shared that she has a 23-year-old non-binary child. “One of the most important things my child has taught me is to see them from the inside and that the changes they’re making on the outside are not as important. As health care providers, we just need to be open. We don’t need to see a person and immediately think ‘Is that person male or female?’ It’s a person. See them for who they are on the inside. Gender is a continuum and individuals can identify somewhere in the middle.”

Another audience member asked Hill how medical professionals can form trust with trans people. Hill responded, “Whether you’re a nurse, doctor, or whatever, when your fear shows, that makes patients scared. Just because you aren’t overtly saying something, doesn’t mean the patient can’t read a room. Interact with people like they’re your neighbour. That fear has to be dismantled. A patient’s safety and vulnerability can’t be met with uncertainty.”

Dr. Falconer agreed and cited a recent study that found discomfort can be quite harmful because patients get less time with the doctor, the doctor asks fewer questions and does a less thorough exam. “In response to that, I think we all need to learn to sit with discomfort. Be with it, learn to apologize quickly, brush it off, and fake it until you make it with comfort. The patients’ lives are in our hands; we don’t want to create a sense of discomfort or fear.”

A crowd of about 80 people sitting in chairs in a room with two presenters at the front.

A large crowd came out to the Belleville General Hospital Education Centre for the discussion on gender identity. Others attended via Zoom.

Quinte Health’s President and CEO, Stacey Daub, was also in attendance for the discussion. She shared that when Quinte Health was developing its new strategy, goals, and values, we learned a lot by speaking to members of the trans community. “They told us they want to feel welcome here and they want to feel like they belong. Also, in situations where they may have an experience that isn’t good, they’re looking to have allies amongst us to help. Lastly, when we don’t have the education for some things, particularly when it comes to transition, we need to respond in a way that builds confidence and shows the path.”

One of Quinte Health’s values is “Value Everyone”, which states that everyone has their own story and is walking a unique path. We value each individual for who they are and appreciate their experiences and the lens through which they view the world. No matter who we are interacting with and for what purpose, we strive to see the whole person and we demonstrate inclusion, equity, dignity and respect, embracing each other’s differences without labels or judgement. Thank you to Hill Werth, Dr. Falconer and the DEI Committee for engaging our team in meaningful discussion and for giving us some insights and skills for providing better care to gender-diverse people within our hospitals.

#Compassion

#Value Everyone