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Evidence to Improve Care

Gender-Affirming Care for Gender-Diverse People

Care for Adults

This quality standard addresses care for gender-diverse adults aged 18 years and older. The term gender-diverse refers to all people whose gender identity or expression differs from the gender typically attributed to the sex assigned to them at birth. The term is inclusive of all Two-Spirit, trans, and nonbinary people. The quality standard focuses on gender-affirming care and the primary care needs of gender-diverse people, including assessment, screening, treatment, and follow-up. It addresses referral for gender-affirming surgery, based on clinical evidence, but not specific surgical procedures.

Although many statements may apply to intersex people, this quality standard does not directly address the care of intersex people.

We are seeking feedback on a draft quality standard and patient guide for gender-affirming care. Submissions will be accepted until May 21, 2024.

Share Feedback

We welcome feedback from the following people from across Ontario:

  • People receiving gender-affirming care and their families and care partners

  • Clinicians

  • Researchers

  • Administrators

Quality Standard – DRAFT

Know what quality care looks like, based on evidence and expert consensus

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Patient Guide – DRAFT

Patients: know what to ask for in your care

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The work on this quality standard started in September 2023.

Ontario Health thanks the following individuals for their generous, voluntary contributions of time and expertise to help create this quality standard:

Erin Ziegler (co-chair)
Associate Professor, Daphne Cockwell School of Nursing, Toronto Metropolitan University
Nurse Practitioner, Queen Square Family Health Team

Nael Bhanji
Associate Professor, Trent University

Dillon Black
Manager of Culture, Equity, and Belonging, Queensway Carleton Hospital

Holly Brown
Lived Experience Advisor
Trans Health Team Lead, Centretown Community Health Centre

Kate Greenaway
Family Physician
Medical Director, Foria Clinic
Consultant, Gender Identity Clinic, Centre for Addiction and Mental Health

Carley Hoja
Social Worker, Kingston Community Health Centres

Susan Hranilovic
Primary Health Care Nurse Practitioner, Department of Family and Community Medicine, Unity Health Toronto

Reed Kiss
Lived Experience Advisor
Primary Care and Pediatric Registered Nurse,
Parkdale Queen West Community Health Centre, McMaster Children’s Hospital

June Lam
Psychiatrist, Centre for Addiction and Mental Health
Lecturer, University of Toronto

Carey Lawford
Social Worker, Adult Gender Identity Clinic, Centre for Addiction and Mental Health

Cathy Maser
Nurse Practitioner, Adolescent Medicine, Hospital for Sick Children

Mackenzie Mawson
Lived Experience Advisor
Mental Health Worker, St. Joseph’s Healthcare Hamilton Youth Wellness Centre

Sean Robinson
Family Physician and Gender-Affirming Care Provider, Waves Family Medicine

Elena Salgado
Lived Experience Advisor
Pharmacist, Outpatient Adult Endocrinology, LMC Healthcare

Ashley Vandermorris
Pediatrician, Division of Adolescent Medicine, Hospital for Sick Children

SJ Vriend
Mental Health Counsellor, Centretown Community Health Centre, Trans Health Program

Angelina Wiwczor
Nurse Practitioner, Health Sciences North,
NEO Kids and Family Program,
Pediatric Ambulatory Care Unit

Ontario Health also thanks the following individuals for their contributions to the development of this quality standard:

Jodi Asphall
Clinical Systems Navigator for Trans and Non-binary Health, Rainbow Health Ontario

Sanober Diaz
Executive Director, Provincial Council for Maternal and Child Health

Taylah Harris-Mungo
Clinical Educator, Trans & Non-binary Health, Rainbow Health Ontario

Sil Hernando
Senior Program Manager, Rainbow Health Ontario

Juan Ortiz
Clinical Educator with Lived Experience, Rainbow Health Ontario

If you have any questions, please send an e-mail to

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