For gender-diverse and sexual minority individuals, finding compassionate, inclusive mental health care can be a challenge. Recently, the Community Psychiatry Clinic (CPC) at St. Joe’s became the permanent home of this critical service to members of the 2SLGBTQ+ community in Hamilton and beyond. The 2SLGBTQ+ Mental Health Clinic, which originated in 2008 as a St. Joe’s partnership with The Well, a grassroots organization, has grown over the years and is providing vital care to people across the region. 

Many of the patients who access care at the clinic are transgender and gender-diverse. The clinic represents more than just access to psychiatric services – it is a safe space where they can be seen and supported without judgement.  

“The vast majority of the people I see in the clinic are trans-identified,” explains Dr. Veltman, psychiatrist at St. Joe’s. “They’re often looking for something very specific—something they feel like they can’t necessarily get at a general psychiatry clinic.”  Dr. Veltman is also the associate chair of equity, diversity, inclusion and Indigenous reconciliation for the department of psychiatry and behavioural neurosciences at McMaster University. 

That “something” may be a consultation for possible ADHD or bipolar disorder, or more often, a letter of support for gender-affirming surgery—care that’s standard in mental health, but frequently complicated by stigma or lack of provider experience. 

“I have people coming from London, Kitchener-Waterloo, Guelph, Niagara Region,” I have one patient who moved during the pandemic, a 10-hour drive away. There’s just no psychiatric care where they are, let alone gender-affirming care.” 

In Ontario, trans patients seeking gender-affirming procedures often require one or even two letters of support from medical or mental health professionals. The St. Joe’s clinic, led by Dr. Veltman, has earned a reputation as a safe, welcoming and affirming space for 2SLGBTQ+ individuals—especially those who have struggled to find compassionate care elsewhere. 

“My patients feel like their trans identities are a barrier to getting good quality psychiatric care. So, they come to a clinic where they know they won’t have to fight to be seen.” 

While the St. Joe’s clinic continues to serve as a critical resource for many, the ultimate goal is for all patients to have access to affirming, compassionate care. 

“To be gender affirming—it’s not difficult,” Dr. Veltman says. “Really, any healthcare provider should be gender-affirming. It’s just affirming someone’s identity. It should not be that hard.” 

Yet she’s honest about the reality: systemic bias and insufficient training continue to pose barriers. 

“We are still living in a very cisgender-focused, transphobic—and when it comes to sexual orientation—still homophobic society,” she says. “Many of my colleagues haven’t had a lot of experience or education working with gender-diverse or sexual minority patients.” 

Things are beginning to change, she acknowledges, particularly among younger medical professionals. 

“Back in 2008, everybody who knew I was doing this work was referring every 2SLGBTQ+ patient to me,” she says. “Now, through better education and faculty development, many feel more confident providing that care themselves.” 

“There has been a shift.” 

Still, the work continues. While the clinic at St. Joe’s remains a vital resource for those seeking gender-affirming psychiatric care, the ultimate aim is to work toward a future where this specialized clinic is no longer necessary. “There still is a need for a specialized clinic like this in certain situations,” states Dr. Veltman. “I see success for the clinic being that we don’t need this clinic. 2SLGBTQ+ folks want to—and should be able to—access healthcare wherever everyone else accesses it. All of us should be able to provide compassionate care to sexual and gender minority patients.”