We noted a dramatic rise in the annual incidence of ONH/SOD, which was strongly associated with poverty and northern communities. The pattern was consistent with environmental or nutritional etiologies. Many children were severely affected with increased morbidity and health care burdens.
Transgender youth in Manitoba seeking GDAAY services have high rates of anxiety and depression. These youth face adversity in health care settings and are distressed over long wait times for mental health services. Recommendations to improve care include increasing general health care providers' education on gender affirmative care, providing gender sensitivity training for health care providers, gathering preferred names and pronouns during triage, increasing visibility of support for LGBT+ persons in clinics, increasing resource allocation to this field and creating policies so all health care settings are safe places for trans youth.
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