The language used and ways in which gender and sexually diverse people self-identify and express themselves has and continues to change. It is important to reflect the ways in which young people self-identify.

Gender identity is linked to a person’s sense of self. It is a person’s internal and individual experience of gender. It is a person’s sense of being a woman, a man, both, neither, or anywhere along the gender spectrum. A person’s gender identity may be the same as or different from their birth-assigned sex. A person’s gender identity is fundamentally different from and not related to their sexual orientation.

Rationale for this question:

• There are strong and documented differences in access to, quality of and outcomes of service amongst gender diverse youth.
• Trans youth have noted factors related to their vulnerability in health-related areas including the lack of safe environments, poor access to physical health services, inadequate resources to address their mental health concerns, and a lack of continuity of caregiving by their families and communities.
• Stigma and fear of discrimination can impact accessing health care by trans, gender non-conforming, and intersex youth. Research shows that 21% of trans people have reported avoidance to accessing emergency care when needed, due to fear of discrimination based on being trans.

Important considerations:

• Some youth may find this question intrusive. Gender diverse, gender non-conforming, and trans youth, may be concerned about who will have access to this information. Youth have the option to skip the question and you should reassure them that their data will be taken care of in the same manner as all of their other sensitive information.
• Past pilots have found that some clients may laugh or make an inappropriate joke when asked this question. It is highly recommended that staff do not engage, and can state, “we ask because we know that trans, gender non-conforming, and intersex clients face harassment and discrimination when accessing services and in healthcare, we believe everyone deserves affirming care”.

Responding to youth asking why they are being asked this question:

• Having this information can help us plan for appropriate programming, staffing, training, and service provision.
• It helps us plan to make sure that all youth feel comfortable and safe in our space.
• We can use this data to understand the experiences of gender diverse youth we work with.

For additional resources, see the YWHO Trans Affirming Care Webinar, and Resource Guide for Providing Trans Affirming Care.