Adverse health outcomes in transgender people/The authors respond to “Adverse health outcomes in transgender people”

In an article in CMAJ, Chan and colleagues reported on the case of a 44-year-old transgender woman with a deep vein thrombosis and history of immobility and high-dose estradiol. The authors state that transgender people often do not have a regular family physician nor ongoing monitoring of their medications and that they may misuse estrogen therapy, leading to higher risks. The latter is not situated as a potential consequence of the former, and the authors overlook the inaccessibility of gender-affirming primary care. To address this issue, programs such as Rainbow Health Ontario and Trans Care BC are expanding and improving access to sustainable gender-affirming care through the development of models of service and clinical resources, education of primary care providers and community engagement projects.