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Providing safe, respectful care drives ED physician’s work with transgender community

Posted Jun 8th, 2022

A doctor in scrubs smiles for the camera.

Dr. Tim St. Amand uses his work at Quest Community Health Centre and in the St. Catharines Site Emergency Department as an opportunity to advocate for greater understanding of the transgender community and ensure safe, compassionate and inclusive healthcare for all.

Dr. Tim St. Amand wears two important hats within the healthcare sector.

He serves as the Emergency Department Site Lead at the St. Catharines Site, managing the physician group, overseeing scheduling and staffing of the department, and implementing new initiatives to enhance care for patients and staff, in addition to providing direct patient care.

In 2016, Dr. St. Amand decided it was time to borrow a page from the bestselling book, The Second Mountain: The Quest for a Moral Life by David Brooks. Inspired by Brooks’ words, he committed to defining a life of meaning and purpose beyond himself by choosing to also work one day a week supporting transgender clients at Quest Community Health Centre in St. Catharines.

Dr. St. Amand uses his work at Quest and in the St. Catharines Emergency Department as an opportunity to advocate for greater understanding of the transgender community and ensure safe, compassionate and inclusive healthcare for all.

“It’s that sense of trying to do the right thing,” Dr. St. Amand says. “It’s the little, tiny corner of the world I’m in and trying to make it better.”

He does that specifically by overseeing the medical transition of transgender clients at Quest, which is the province’s second-largest transgender clinic, having cared for more than 1,000 clients since 2010.

Dr. St. Amand is part of a team at Quest that includes one other physician, a nurse practitioner and a social worker. He prescribes and monitors hormone therapy for transgender people who come from as far away as Windsor or Sudbury, underscoring the challenges they can face finding compassionate care.

Providing high-quality care with dignity is simple, he explains, and he models that at Niagara Health.

It’s always using a person’s preferred name and pronouns, even if they’re different than what appears on their health card. It’s also remembering that transgender patients experience the same illnesses as others.

“Transgender is not an abnormal gender, it’s just not a common gender,” he says. “It’s a normal thing. It’s been around since the beginning of time.”

Still, many in the transgender community feel the onus is on them to teach healthcare providers how to care for them “when that’s not really their role when they’re not feeling well,” Dr. St. Amand says. That compels him in his work to be an advocate, ally and to educate others about supporting the transgender community.

“It’s asking for and using the names and pronouns patients use and normalizing that practice,” he says. “It’s having empathy.”

Each June, Niagara Health celebrates Pride Month. We are sharing stories like these to highlight the work being done to support diversity, equity and inclusion. 

Making the transition

There are three types of gender transition.

Social: This can include presenting one’s identified gender in public by changing names, pronouns, ways of dress and coming out to family, friends, coworkers and others.

Medical: This includes hormone therapy, including the prescription of testosterone to transgender males to masculinize the body or estrogen and testosterone blockers to transgender females to feminize the body.

Surgical: There are different types of gender-affirming surgery to align the body with gender identity. It’s up to the individual to decide if surgery of any kind will be part of their transition.

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