Influence of spoken language and gender identity on healthcare experiences of transgender and non-binary youth living in Quebec, Canada

Whether spoken language influences experiences of trans and non-binary youth (TNBY) with healthcare systems is unknown. We analyzed Quebec data from the Canadian Trans and Non-Binary Youth Health Survey to illustrate healthcare experiences of predominantly French-speaking TNBY aged 14–25 and influence of gender identity and language on those experiences. We included 220 participants of whom 71% identified as French-speaking. Up to 78% reported a mental health problem and 51% reported foregoing mental health care in the last year. Only 26% of non-binary versus 57% of trans youth were comfortable discussing healthcare needs with providers (OR 0.26; 95% CI [0.13–0.54]). English youth were less likely than French youth to be comfortable discussing healthcare needs (aOR 0.33, 95% CI [0.13–0.83]. They were also more likely to forgo care because of negative experiences (aOR 2.21, 95% CI [1.00, 4.87]) and out of fear (aOR 2.38, 96% CI [1.08, 5.28]). Our study found that TNBY had a high prevalence of foregone health care despite a great need. In Quebec, a predominantly French-speaking area within Canada, language-minority English TNBY were less comfortable than French TNBY discussing healthcare needs and accessing needed resources. Limited availability of language-specific resources may be an additional barrier to healthcare access for TNBY.