PTP PINK PAPER
2SLGBTQIA+ Health Disparities In Canada
The Pink Paper on Health offers an unprecedented national overview of 2SLGBTQIA+ health and healthcare experiences in Canada, representing one of the most detailed studies to date. The evidence it presents shows how Canada’s healthcare system currently fails to meet the needs of 2SLGBTQIA+ communities, particularly in rural and racialized contexts. Respondents described profound experiences of exclusion, stigma, and mistrust, all of
which undermine care and contribute to a cycle of unmet health needs. This report therefore offers data designed to give policymakers, educators, and healthcare providers a clear direction to begin closing these gaps. Ensuring equitable and affirming care for 2SLGBTQIA+ people is not only a matter of health justice—it is an evidence-based imperative.
Key Findings
- 40% of 2SLGBTQIA+ individuals reported a diagnosed mental health condition, twice the rate of non-2SLGBTQIA+ participants (20%).
- Depression severity was highest among pansexual (47%) and asexual (45%) individuals, more than double that of non-2SLGBTQIA+ respondents (22%).
- Anxiety severity was highest among pansexual respondents (50%), over twice what non-2SLGBTQIA+ respondents (24%) experience. Queer (45%), asexual (47%), and Two-Spirit (45%) respondents also report disproportionately high rates of anxiety.
- Cancer prevalence was alarmingly high among asexual (15%) and gay (11%) individuals, more than double the rate of non-2SLGBTQIA+ participants (5%).
Across physical, psychological, environmental, and social domains, 2SLGBTQIA+ respondents consistently reported lower Quality of Life (QoL) scores than their non-2SLGBTQIA+ counterparts. These disparities were not experienced in isolation. Our intersectional analysis revealed that social determinants of health, such as income, education, and geography, shape and amplify negative outcomes.
The services 2SLGBTQIA+ individuals identify as being the most important (e.g. mental health care and gender-affirming treatments) are reported as the least accessible and least satisfying.
Satisfaction with mental health services was below 30% among 2SLGBTQIA+ respondents overall and even lower among asexual (12%), queer (11%), genderfluid (3%), and Two-Spirit (3%) individuals.
Up to 77% of Two-Spirit respondents reported experiencing discrimination in healthcare settings. Many described having to hide their identity, explain basic aspects of their existence to providers, or lie about their gender or sexual orientation to avoid being dismissed, misgendered, denied care, or treated with hostility.
Experiences of discrimination were more prevalent among racialized and rural respondents, underlining the compounded effects of intersectional marginalization and the unevenness of care across geographic regions.
Inconsistent service delivery (especially in rural and remote areas) makes many individuals less likely to seek care when they need it.
56% of 2SLGBTQIA+ individuals turn to online platforms for health information compared to 40% of their cisgender and heterosexual counterparts. These higher rates are due to related factors of lack of access to care and widespread mistrust in the system.
Recommendations for actionable change
Academic institutions, educators, and policymakers should actively partner with 2SLGBTQIA+ communities to ensure health curricula audits and reforms address the issues that matter to 2SLGBTQIA+ people living in Canada. Embedding inclusive, evidence-based training that centres gender diversity, trauma-informed care, and anti-oppressive practices across all levels of education and professional development will lead to more equitable care.
Increased access to culturally competent, publicly funded mental health care, including gender-affirming services supports everyone across Canada. However, mandatory training in 2SLGBTQIA+ competency and trauma-informed approaches will ensure 2SLGBTQIA+ individuals benefit equally from these services.
Respectful, standardized practices for collecting sex and gender identity data should be implemented at the federal level to support early identification of disparities and inform equitable care and policy.
Policymakers, healthcare providers, and community groups should co-create cancer screening and chronic disease prevention programs tailored to 2SLGBTQIA+ populations, addressing unique barriers like discrimination and care avoidance.
Researchers and academic partners should lead a Canada-wide scan to map services, identify gaps, and highlight regional strengths. These findings will support more strategic planning and resource allocation that addresses existing gaps.
Federal and provincial efforts to strengthen 2SLGBTQIA+ care in underserved areas through incentives, virtual care models, and community-led clinics will help prevent care quality from being dependent on geography. Policymakers should consult with service providers and individual communities to improve access in impactful ways.
Prioritizing lived experience and the leadership of 2SLGBTQIA+ individuals helps institutions, researchers, and health leaders authentically represent real perspectives in Canada. Hiring roles like peer navigators and equity officers can reduce self-advocacy burdens and foster trust in care systems.
2024 PTP PINK PAPER
2SLGBTQIA+ Representation in Canada’s Screen Industries
Below are some of the most remarkable findings from the 2024 PTP Pink Paper:
- 93% of industry professionals agree that 2SLGBTQIA+ representation on Canadian screens is extremely important to them.
- 90% of media professionals agree that on-screen representation increases understanding and drives acceptance of 2SLGBTQIA+ people in society at large.
- 82% of respondents believe 2SLGBTQIA+ representation is uneven. Gay men are seen as significantly less underrepresented than any other group. Gay men are also less likely to perceive underrepresentation of 2SLGBTQIA+ identities on screen.
- People who are Two-Spirit, trans, and gender diverse are the most underrepresented. It is difficult to find work that features intersex and asexual characters, even outside mainstream broadcast networks and publishers.
- Only 10% of 2SLGBTQIA+ characters in top-rated shows have speaking roles.
- Although we now see more 2SLGBTQIA+ representation on Canadian screens, these portrayals are often understood to be inaccurate. The vast majority of respondents feel that 2SLGBTQIA+ representation is often superficial and troublingly reliant on tropes and stereotypes.
- Intersectionality remains a significant gap. Only 4% of the most popular English productions and 2% of French ones featured BIPOC 2SLGBTQIA+ characters.
- Top barriers were identified to be the lack of 2SLGBTQIA+ decision makers, cautious industry executives, storytelling tropes and stereotypes, tokenizing professionals, lack of financial support, and few mentorship and career opportunities.
- Among other areas to continue working on are better marketing of 2SLGBTQIA+ created content, safer working environments, and intersectional representation across various genres.