Positive and negative mental health care experiences among transgender and non-binary people in Canada.

Unmet mental health care need among transgender and non-binary (TNB) people is high, largely due to structural barriers to care resulting from stigma. Prior research has employed broad measures of access to general mental health care among TNB people, but to further improve access, it is important to understand the experiences of TNB people with specific types of providers and services. We sought to describe positive and negative TNB-specific experiences of TNB people accessing mental health care in Canada and compare the frequency of TNB-specific experiences across participant demographics, type of service sought, and type of provider. Of 1320 participants who accessed services and were included in this analysis, 31% indicated accessing multiple services and 67.3% indicated multiple provider types. Twenty percent did not indicate any positive experiences, while 19.8% reported one or two, and 60.2% indicated three or more. Sixty-three percent of participants did not indicate any negative experiences, while 26.7% reported one or two, and 10.6% reported three or more. Groups most often reporting three or more negative experiences included those aged 14-24, those with a history of sex work, unstable housing, disability, and/or those who talked to a nurse or accessed eating disorder services. Further research should explore specific elements of training necessary to provide competent care for TNB individuals and other subgroups experiencing higher levels of negative experiences.