Our findings illustrate the stark contrast and health inequities between trans and non-binary people and the general population, especially in the areas of mental health and wellbeing, including the very high rates of psychological distress and suicide attempts within our communities.

One of the goals of this research project was to explore possible reasons for these health inequities. This report shows many trans and non-binary people cannot access medically necessary gender-affirming care. This care is often simply not available within the public health system. Other barriers we identified include cost, lack of information about how to access services, long waiting lists and gaps in health providers’ knowledge about gender affirming care. Participants described other barriers they faced when they were trying to access healthcare. These included being asked unnecessary or inappropriate questions and being referred to by the incorrect name or gender, which meant that many participants delayed or avoided seeking care.

Our findings illustrate the huge personal impact of the stigma that people face for being trans or non-binary. Counting Ourselves participants reported widespread discrimination, especially in public places, trying to find a job or housing and at work. Most did not have the correct gender marker on their identity documents, and many of these participants reported that this resulted in harassment and other negative and stressful experiences in many areas of their lives. We also found high rates of harassment and violence against trans and non-binary people, including by family members and partners.

We found reasons to be hopeful for the future. Trans and non-binary youth were more likely to have grown up with a family/wh_nau member who helped them to legally transition or researched how best to support them. Participants who were supported by their family/wh_nau were also more likely to have positive mental health.