Why this is important
In Nova Scotia, we do not all experience healthcare in the same way. For Black queer and trans folks, there is a real and significant absence that persists in research and data that captures real experiences when trying to access inclusive and culturally appropriate care. Without this critical information, it is hard to be able to address what is going on and to make changes to a system that was not built with inclusion and representation in mind.
For many, navigating healthcare is far from straightforward. Black queer and trans healthcare experiences are shaped by racism, transphobia, queerphobia and systemic biases and how these issues overlap and impact one another. Their experiences aren’t just stories or isolated incidents, they are supported by research showing consistent patterns of harm, exclusion, and unmet needs. Research and studies from our communities consistently document higher rates of negative encounters with healthcare providers, more barriers to receive care, and worse health outcomes (Pang et al, 2025).
This blog explores these realities through the experiences of Black queer and trans people living in Nova Scotia. It will draw from our research, community reports, and lived experiences to highlight not only the barriers black LGBTQ+ people face when seeking care, but also to create a safe space for this community to share your own healthcare experiences. Your experiences, whether they are frustrating, painful, or hopeful, are essential to taking actions to provide evidence-based, culturally competent health care to this population.
Throughout this project, it became clear that there was a lack of research and data on the health of LGBTQ+ black populations in Nova Scotia. Studies from outside of the province showed discrimination and stigma rooted from sexual orientation, gender identity, and race, directly shape the health care experiences of black queer and trans people (Colpitts & Gahagan, 2016). When you consider that Atlantic Canada tends to have poorer health outcomes compared to other provinces across the country, the lack of data specific to this community becomes a priority health concern for this group.
Healthcare barriers and access challenges are significant health concerns for this population. Social determinants of health including socioeconomic status, access to stable housing, education, and social isolation, strongly influence the health outcomes of black queer and trans people endure. These factors affect all populations but the ways they intersect with black queer and trans people create health inequities that are important to recognize compared to their white counterparts. Structural inequities contribute to heightened barriers to care for including lack of access to community informed healthcare services, non-affirming and often hostile clinical environments, and poorly developed healthcare pathways that lack cultural competence and patient centered care. To illustrate the reality of these common issues, we will include comics throughout this segment that depict lived healthcare experiences and highlight how these barriers and determinants affect everyday health and wellbeing for the black LGTBQ+ communities.
Lack of research
Healthcare barriers & Access Challenges
Access to gender affirming care
Primary care access issues
Effects of poverty, uninsured care gaps
Lack of culturally competent healthcare providers
Intersectional: race, gender, sexuality
Multiple forms of discrimination (racism, transphobia, queerphobia,
Experience with healthcare providers
Respect and pronoun use
Kinship with provider with similar background
Misgendering, using incorrect name
Provider assumption and bias
Experience through the transition process
Trauma vs supportive care
Education and training of healthcare providers
Mental health experiences
Impact of systemic discrimination on mental health
Access to black providers
Barriers to crisis support and long term support
Community based practices
Sexual and reproductive healthcare
PrEP/PEP access
Trans reproductive care